Mike S Davenport, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209.005569 Issued in IL

Practice address

206 S Washington St
MC Leansboro, IL 62859-1139

Phone

(618) 643-2835

Fax

(618) 643-2891

NPI assigned

May 20, 2006

Sex

Male

Sole proprietor

No

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.

• Eldorado Emergency Group PC

  • Emergency Medicine Physician
  • Eldorado, IL
  • NPI 1235868191
  Medicare reassignment Care Compare group NPD IL · NURSE PRACTITIONER
• Ferrell Hospital Community Foundation

  • Critical Access Hospital
  • Eldorado, IL
  • NPI 1194713404
  Medicare reassignment NPD IL
• Ferrell Hospital Community Foundation

  • Multi-Specialty Clinic/Center
  • Harrisburg, IL
  • NPI 1124905351
  NPD FAMILY MEDICINE
• Crossroads Physicians Corp

  • Family Medicine Physician
  • Mount Vernon, IL
  • NPI 1508850520
  NPD (past) FAMILY MEDICINE
• Ferrell Hospital Community Foundation

  • Rural Health Clinic/Center
  • MC Leansboro, IL
  • NPI 1689217820
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ferrell Hospital Community Foundation

  • Rural Health Clinic/Center
  • Carmi, IL
  • NPI 1134650997
  Care Compare affiliation Hospital
• Ferrell Hospital Community Foundation

  • Rural Health Clinic/Center
  • Harrisburg, IL
  • NPI 1184202392
  Care Compare affiliation Hospital
• Ferrell Hospital Community Foundation

  • Critical Access Hospital
  • Eldorado, IL
  • NPI 1194713404
  Care Compare affiliation Hospital
• Ferrell Hospital Community Foundation

  • Rural Health Clinic/Center
  • Eldorado, IL
  • NPI 1457586620
  Care Compare affiliation Hospital
• Ferrell Hospital Community Foundation

  • Rural Health Clinic/Center
  • MC Leansboro, IL
  • NPI 1689217820
  Care Compare affiliation Hospital
• Ferrell Hospital Community Foundation

  • Rural Health Clinic/Center
  • Eldorado, IL
  • NPI 1700011046
  Care Compare affiliation Hospital
• Richland Memorial Hospital, Inc

  • Critical Access Hospital
  • Olney, IL
  • NPI 1467492124
  Care Compare affiliation Hospital

Specialty

Nurse Practitioner

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eldorado Emergency Group PC 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ferrell Hospital Community Foundations Hospital, Eldorado, IL, CCN 141324
• Carle Richland Memorial Hospital Hospital, Olney, IL, CCN 141355

Merit-based Incentive Payment System (MIPS)

Final score

91.05 of 100Reported as apm

Quality

72.1

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

98.25 of 100Reported as group

Quality

100

Improvement activities

40

Cost

73.66

Medicare fee-for-service enrollment

Enrolled in IL

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mdavenport85928@direct.deaconess.com

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 22, 2022.

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650585600000",
    "number": "1295789576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 S WASHINGTON ST",
            "city": "MC LEANSBORO",
            "state": "IL",
            "postal_code": "628591139",
            "telephone_number": "618-643-2835",
            "fax_number": "618-643-2891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 S WASHINGTON ST",
            "city": "MC LEANSBORO",
            "state": "IL",
            "postal_code": "628591139",
            "telephone_number": "618-643-2835",
            "fax_number": "618-643-2891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "MIKE",
        "middle_name": "S",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2022-04-22",
        "certification_date": "2022-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.005569",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.005569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Ann Burns, PA-C
• Jeanie Chamness, PA-C
• Inessa Chernysh, DO
• Asuncion R. Cope, M.D.
• Megan Cross, OTA
• Deaconess Specialty Physicians, Inc
• Ferrell Hospital Community Foundation
• Ferrell Hospital Community Foundation
• Fox Meadows SLF LP
• Freds Stores of Tennessee Inc

• All providers in MC Leansboro, IL
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2022; 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.