Donald D Davenport Jr D O P a

Primary specialty

Surgical Critical Care PhysicianTaxonomy code 2086S0102X

License

L0118 Issued in TX

Legal business name

DONALD D DAVENPORT JR D O P A

Practice address

540 W 5TH St Ste 470
Odessa, TX 79761-5070

Phone

(432) 580-8330

Fax

(432) 580-8333

NPI assigned

Mar 19, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Donald D Davenport Jr., D.O.NPI 1982608964

Title

Owner Physician

Phone

(432) 580-8330

Specialties & licenses 6

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.61679

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Donald D Davenport Jr., D.O.

  • Surgery Physician
  • Odessa, TX
  • NPI 1982608964
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208131200000",
    "number": "1053435362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 W 5TH ST STE 470",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797615070",
            "telephone_number": "432-580-8330",
            "fax_number": "432-580-8333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 W 5TH ST STE 470",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797615070",
            "telephone_number": "432-580-8330",
            "fax_number": "432-580-8333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DONALD D DAVENPORT JR D O P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2008-04-14",
        "status": "A",
        "authorized_official_last_name": "DAVENPORT",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER PHYSICIAN",
        "authorized_official_telephone_number": "432-580-8330",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "TX",
            "license": "L0118",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Surgical Critical Care",
            "state": "TX",
            "license": "L0118",
            "primary": true
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Pediatric Surgery",
            "state": "TX",
            "license": "L0118",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Trauma Surgery",
            "state": "TX",
            "license": "L0118",
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Surgical Oncology",
            "state": "TX",
            "license": "L0118",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Colon & Rectal Surgery",
            "state": "TX",
            "license": "L0118",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP # BCBS",
            "identifier": "0017HG",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Divine Care Home Services, LLC
• Bryn Dodd, LPC
• William H Dodson, PT, DSC, OCS, CHT
• Brianna Dominguez
• Jason Roland Dominguez, PA-C
• Dorado RX Pharmacy,LLC
• John H Doran, M.D.
• Daniel Paul Dorethy, LPC,LCDC,,MAC,M.ED.
• Jacquelynn Dorman, FNP
• John Kyle Dorman, MD

• Surgical Critical Care Physician in Odessa, TX
• Providers in Odessa, TX by specialty
• Surgical Critical Care Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.