Individual provider Active NPI

Gail Lynn Davenport, ARNP-C

  • Adult Health Nurse Practitioner
  • St Petersburg, FL
National Provider Identifier
1104059120
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN3351742 Issued in FL
Practice address
6017TH St S
St. Petersburg, FL 33701-4748
Phone
(727) 893-6234
Fax
(727) 553-7798
NPI assigned
Aug 25, 2009
Last updated
Nov 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN3351742 FL
Acute Care Nurse Practitioner 363LA2100X ARNP3351742 FL
Adult Health Nurse Practitioner 363LA2200X APRN3351742 FL Primary

Addresses

Primary practice location

6017TH St S
St. Petersburg, FL 33701-4748

Mailing address

601 7TH St S
St Petersburg, FL 33701-4708
Phone (727) 893-6234

Other identifiers 1

IdentifierTypeStateIssuer
109410700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190913002597 FL Practitioner - Nurse Practitioner 5294064317 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohi West Medical Group LLCGroup PAC ID 2668882507, 200 clinicians

Practice addresses (Care Compare)

601 7TH St S
Suite 205
St Petersburg, FL 33701-4748
Phone (727) 893-6234

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP3351742FLMDAcute Care Nurse Practitioner
APRN3351742FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health, Inc. Current Accepting new patients
Ohi West Medical Group, LLC CurrentSince Nov 30, 2021 Accepting new patients
Ohi West Medical Group, LLC CurrentSince Nov 30, 2021 Accepting new patients

Locations

1414 Kuhl Ave
#38
Orlando, FL 32806
Phone (407) 481-7179

601 7th St S
St Petersburg, FL 33701
Phone (727) 572-0900

601 7th St S
Ste 205
St Petersburg, FL 33701
Phone (727) 893-6234

603 7th St S
Ste 450
St Petersburg, FL 33701
Phone (727) 822-6666

701 6th St S
St Petersburg, FL 33701
Phone (727) 450-1144

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: gdavenport305724@orlandohealth.medalliesdirect.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1251158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1104059120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 7TH ST S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014708",
            "telephone_number": "727-893-6234",
            "fax_number": "727-553-7798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6017TH ST S",
            "city": "ST. PETERSBURG",
            "state": "FL",
            "postal_code": "337014748",
            "telephone_number": "727-893-6234",
            "fax_number": "727-553-7798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "GAIL",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "ARNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-25",
        "last_updated": "2024-11-05",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN3351742",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "ARNP3351742",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN3351742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109410700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.