Jeffrey Craig Davenport, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

24933 Issued in OK

Practice address

3815 S Boulevard
Edmond, OK 73013-5479

Phone

(405) 285-7568

Fax

(405) 285-7634

NPI assigned

Jul 6, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 1, 2015 through Oct 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Jeffrey C Davenport MD PC

  • Family Medicine Physician
  • Edmond, OK
  • NPI 1396924015
  NPD (past) Authorized official
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553644800000",
    "number": "1336171925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3815 S BOULEVARD",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730135479",
            "telephone_number": "405-285-7568",
            "fax_number": "405-285-7634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3815 S BOULEVARD",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730135479",
            "telephone_number": "405-285-7568",
            "fax_number": "405-285-7634"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3824 S. Boulevard",
            "address_2": "Suite 160",
            "address_purpose": "LOCATION",
            "city": "Edmond",
            "state": "OK",
            "postal_code": "730135478",
            "country_code": "US",
            "telephone_number": "405-348-2424",
            "fax_number": "405-348-2435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "JEFFREY",
        "middle_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2019-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "24933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200089300A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leah Lenee Danley, LPC
• Margaret Darcey Schifferdecker, LCSW
• Esperanza Darling
• Rashell J. Daughty, BHRS
• Amanda Robin Davenport, L.P.C.
• David J Short PHD
• Lindsey Nicole Davidson, BD
• Erika Allison Davis Shade, MCMHC, LPC
• Allison Rae Davis, PA-C
• Ashton Pierre Davis

• Family Medicine Physician in Edmond, OK
• Providers in Edmond, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2019; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.