KELLY VAN DAVIS (M.D.) – Internal Medicine Physician, NPI 1871554139
Internal Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,474 INTERNAL MEDICINE in OK
Provider Addresses for KELLY VAN DAVIS (M.D.)
1202 W CHEROKEE ST STE H
WAGONER, OK 744674629
Phone: (918) 614-5533
Fax: (918) 485-6020
Type: Location
10907 S KNOXVILLE AVE STE B
TULSA, OK 741376624
Phone: (918) 299-0323
Fax: (918) 299-0323
Type: Location
10907, South Knoxville Avenue, Tulsa, Oklahoma, 74137, United States
TULSA, OK 741376624
Phone: (918) 978-5588
Fax: (918) 299-0323
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $53.
Total Amount is formed as General ($53) + Research ($0) + Ownership ($0) = $53.
Last reported payment date: 2023-08-31 • Largest payer in this snapshot: Ultragenyx Pharmaceutical Inc. ($23).
Total Amount
$53
General + Research + Ownership
Payments
3
Total payment records
General Amount
$53
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-08-31
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Ultragenyx Pharmaceutical Inc. | $23 |
| Lilly USA, LLC | $16 |
| Novo Nordisk Inc | $14 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2013-01-22
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20060719000251 | I | Internal Medicine | OK | TBD |
| I20130122000230 | I | Internal Medicine | TX | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 288 | 186 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 236 | 160 | $0 |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | 155 | 120 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 115 | 115 | $0 |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | 104 | 92 | $0 |
Insurance plans in this area (ZIP 74467)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Clinical Psychologist | OK | |
| Clinical Social Worker | OK | |
| Registered Dietitian Or Nutrition Professional | OK | |
| Family Practice | OK | |
| Family Practice | OK | |
| Internal Medicine | TX | |
| Family Practice | OK | |
| - | OK | |
| P S Y C H I A T R Y | OK | |
| Mental Health Counselor | OK |
Reviews
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