Individual provider Active NPI

Karen B Davenport, PH.D.

  • Clinical Neuropsychologist
  • Marlton, NJ
National Provider Identifier
1124218318
Registry record updated Jul 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
35SI00404200 Issued in NJ
Practice address
92 Brick Rd
Marlton, NJ 08053-2177
Phone
(856) 988-4127
Fax
(609) 261-7199
NPI assigned
Jul 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 35SI00404200 NJ Primary

Addresses

Primary practice location

92 Brick Rd
Marlton, NJ 08053-2177

Mailing address

1 Cortland Shire Dr
Moorestown, NJ 08057-3944
Phone (856) 261-0067

Other names 1

  • Karen Bissiri Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041223000218 NJ Practitioner - Clinical Psychologist 6406814326 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kessler Professional Services LLCGroup PAC ID 2860462652, 42 clinicians

Practice addresses (Care Compare)

1199 Pleasant Valley Way
West Orange, NJ 07052-1424
Phone (973) 731-3600

Merit-based Incentive Payment System (MIPS)

Final score
84.21 of 100Reported as group
Quality
78.56
Improvement activities
40
Cost
70.02

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
35SI00404200NJMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kessler Professional Services LLC CurrentSince Nov 1, 2016 Accepting new patients
Neurorehab Institute LLC Clinical Neuropsychologist Past Accepting new patients
Gerald Tramontano Senior Care Residential and Community Program Clinical Neuropsychologist Past Accepting new patients

Locations

92 Brick Rd
Marlton, NJ 08053
Phone (856) 988-4124

1199 Pleasant Valley Way
West Orange, NJ 07052
Phone (973) 414-4755

4714 Gettysburg Rd
Mechanicsburg, PA 17055
Phone (888) 735-6332

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185321600000",
    "number": "1124218318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CORTLAND SHIRE DR",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080573944",
            "telephone_number": "856-261-0067",
            "fax_number": "609-261-7199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 BRICK RD",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080532177",
            "telephone_number": "856-988-4127",
            "fax_number": "609-261-7199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "KAREN",
        "middle_name": "B",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-25",
        "last_updated": "2007-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NJ",
            "license": "35SI00404200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAREN",
            "last_name": "BISSIRI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Marlton, NJ

Sources for this page

Verify at the official NPI Registry.