Kimbrelle Davenport

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-21-184964 Issued in GA

Practice address

5163 Roswell Rd
Atlanta, GA 30342-2206

Phone

(404) 966-8524

NPI assigned

Oct 19, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Dogwood Autism Services, LLC

  • Behavior Analyst
  • Atlanta, GA
  • NPI 1437674587
  NPD
• Level Ahead Georgia LLC

  • Behavior Analyst
  • Waverly Hall, GA
  • NPI 1982314399
  NPD (past)

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

{
    "created_epoch": "1634601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634601600000",
    "number": "1104589845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2894 3RD AVE SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303158926",
            "telephone_number": "404-966-8524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5163 ROSWELL RD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303422206",
            "telephone_number": "404-966-8524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "KIMBRELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-19",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "GA",
            "license": "RBT-21-184964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronak Dave
• Umang Dave, CMT
• Agena Renee Davenport-Nicholson, MD
• Aalayah Rasheed Davenport
• Jessica Davenport, RN
• Laura Davenport, CPNP
• Lauren Davenport
• Mary Grace Davenport, LMSW
• Misty Davenport
• Sadie Davenport, PA-C

• Behavior Technician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Behavior Technician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.