Active NPI
Tyraya Davenport
- Homemaker
- Cleveland, OH
National Provider Identifier
1225631864
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Homemaker
- Practice address
- 15235 Lake Shore Blvd
Cleveland, OH 44110-1230 - Phone
- (216) 203-0949
- NPI assigned
- Nov 17, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | OH | ||
| In Home Supportive Care Agency | 253Z00000X | OH | ||
| Personal Care Attendant | 3747P1801X | OH | ||
| Child Intellectual and/or Developmental Disabilities Respite Care | 385HR2060X | OH | ||
| Homemaker | 376J00000X | OH | Primary |
Addresses
Primary practice location
15235 Lake Shore Blvd
Cleveland, OH 44110-1230
Mailing address
15235 Lake Shore Blvd
Cleveland, OH 44110-1230
Phone (216) 203-0949
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831678 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605571200000",
"number": "1225631864",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15235 LAKE SHORE BLVD",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441101230",
"telephone_number": "216-203-0949"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15235 LAKE SHORE BLVD",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441101230",
"telephone_number": "216-203-0949"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVENPORT",
"first_name": "TYRAYA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-17",
"last_updated": "2020-11-17",
"certification_date": "2020-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "OH",
"license": null,
"primary": false
},
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": "OH",
"license": null,
"primary": false
},
{
"code": "3747P1801X",
"taxonomy_group": "",
"desc": "Technician, Personal Care Attendant",
"state": "OH",
"license": null,
"primary": false
},
{
"code": "385HR2060X",
"taxonomy_group": "",
"desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
"state": "OH",
"license": null,
"primary": false
},
{
"code": "376J00000X",
"taxonomy_group": "",
"desc": "Homemaker",
"state": "OH",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1831678",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.