Julie Kersti Davenport, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

117904 Issued in MN

Practice address

6540 Penn Ave S
Richfield, MN 55423-1143

Phone

(612) 866-3040

Fax

(612) 866-3050

NPI assigned

Oct 4, 2022

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

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• Grand St Paul CVS LLC

  • Pharmacy
  • Plymouth, MN
  • NPI 1437620903
  NPD (past)
• Grand St Paul CVS LLC

  • Pharmacy
  • Richfield, MN
  • NPI 1861760738
  NPD (past)

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

{
    "created_epoch": "1664841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1245955160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1239 JEFFERSON AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551052808",
            "telephone_number": "651-485-7624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6540 PENN AVE S",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "554231143",
            "telephone_number": "612-866-3040",
            "fax_number": "612-866-3050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1239 Jefferson Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551052808",
            "country_code": "US",
            "telephone_number": "651-485-7624",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "JULIE",
        "middle_name": "KERSTI",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-04",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "117904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mikaela J Daniels, PA-C
• Breana Lynn Daoust I
• Brooke Noelle Darst Rice, PT
• Sara Bernadette Dauphinais, PA-C
• Christina Davenport
• Thomas Dennis Davin, M.D.
• Laura L. Davis, R.N.
• Elyas De Backer
• Maria Lourdes Nolasco De Leon, BSN,RN
• Michael B Debrule, DPM

• Pharmacist in Richfield, MN
• Providers in Richfield, MN by specialty
• Pharmacist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2022; 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.