Jackson Davenport Vision, Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

JACKSON DAVENPORT VISION, INC.

Practice address

218 Old Trolley Rd
Summerville, SC 29485-4929

Phone

(843) 871-9750

Fax

(843) 873-6197

NPI assigned

Oct 4, 2006

Last updated

May 25, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Kenneth Richard Davenport II

Title

President

Phone

(843) 871-9750

Specialties & licenses 3

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Alyssa Davenport, OD

  • Optometrist
  • Summerville, SC
  • NPI 1336079144
  NPD (past)
• Ferine N. Johannes, O.D.

  • Optometrist
  • Beaufort, SC
  • NPI 1821110578
  NPD (past)

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779667200000",
    "number": "1184719387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 OLD TROLLEY RD",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294854929",
            "telephone_number": "843-871-9750",
            "fax_number": "843-873-6197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 OLD TROLLEY RD",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294854929",
            "telephone_number": "843-871-9750",
            "fax_number": "843-873-6197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON DAVENPORT VISION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2026-05-25",
        "certification_date": "2026-05-25",
        "status": "A",
        "authorized_official_last_name": "DAVENPORT",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-871-9750",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "589",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "SC",
            "license": "686",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DA9858",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• David West Ivey, DMD
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• Jackson Pediatric Dentistry of Summerville
• Ebony Louise Jackson
• Mandy Jackson
• Megan Kayla Jackson
• Nancy Pritchard Jackson, MPT

• Optometrist in Summerville, SC
• Providers in Summerville, SC by specialty
• Optometrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2026; 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.