Hyrum Davenport, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

NP-913A Issued in ID

Practice address

4650 Hawthorne Rd Ste 3B
Chubbuck, ID 83202-2376

Phone

(208) 252-5621

Fax

(208) 648-4167

NPI assigned

Jun 4, 2009

Last updated

Sep 23, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Enrolled in ID, UT2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Canvi Behavioral Health PLLCGroup PAC ID 0941692073, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Canvi Behavioral Health PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Chubbuck, ID
  • NPI 1144984873

  UT

  Medicare reassignment Care Compare group NPD
• MVH BMC LLC

  dba Blackfoot Medical Center

  • Family Medicine Physician
  • Blackfoot, ID
  • NPI 1649699174

  Nurse Practitioner

  Medicare reassignment NPD
• MVH BMC LLC

  dba Blackfoot Medical Center

  • Rural Health Clinic/Center
  • Blackfoot, ID
  • NPI 1467816579
  NPD
• Answers, LLC

  • Adult Mental Health Clinic/Center
  • Idaho Falls, ID
  • NPI 1750705687
  NPD (past)

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

{
    "created_epoch": "1244073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758585600000",
    "number": "1255567210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2516",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832062516",
            "telephone_number": "208-252-5621",
            "fax_number": "208-648-4167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 HAWTHORNE RD STE 3B",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832022376",
            "telephone_number": "208-252-5621",
            "fax_number": "208-648-4167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "HYRUM",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-04",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "NP-913A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Covey Jr., LMFT
• Courtney Critchfield, DPT, PT
• Collin Crook
• Cross LTC Pharmacy, LLC (Cross Pharmacy)
• Custom Rehab LLC
• Matece Lydia Davis, LMSW
• Nicholas Davis, LPC
• Sagean Daw
• Matthew Mitchell Day, APRN-CNP
• Matthew R Decker, PHARM.D.

• Nurse Practitioner in Chubbuck, ID
• Providers in Chubbuck, ID by specialty
• Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.