Individual provider Active NPI

Jeffrey Davenport Georgia, M.D.

  • Diagnostic Radiology Physician
  • Presque Isle, ME
National Provider Identifier
1417921842
Registry record updated May 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
036.177198 Issued in IL
Practice address
140 Academy St
Presque Isle, ME 04769-3102
Phone
(207) 768-4000
NPI assigned
Feb 14, 2006
Last updated
May 6, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 036.177198 IL Primary
Diagnostic Radiology Physician 2085R0202X MD21428 ME

Addresses

Primary practice location

140 Academy St
Presque Isle, ME 04769-3102

Mailing address

11 Everett Dow Dr
Woolwich, ME 04579-4571
Phone (207) 730-0954

Other practice location 1

22 Roulston Rd
Windham, NH 03087-1209
Phone (855) 301-0563

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170607001351 ME Practitioner - Diagnostic Radiology 4880684794 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Geisel School of Medicine at Dartmouth, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Aroostook Medical CenterGroup PAC ID 1153233663, 117 clinicians
Lucidsolutions IncGroup PAC ID 0749603462, 84 clinicians

Practice addresses (Care Compare)

118 Bennett Dr
Suite 130
Caribou, ME 04736-2052
Phone (207) 498-3476

140 Academy St
Presque Isle, ME 04769-3102

146 Academy St
Presque Isle, ME 04769-3102

50 Island Rd
Limerick, ME 04048-4053
Phone (614) 340-7740

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.33 of 100Reported as group
Quality
71.56
Promoting interoperability
96
Improvement activities
40
Cost
76.21

Merit-based Incentive Payment System (MIPS)

Final score
91.19 of 100Reported as group
Quality
77.88
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036.177198ILMDDiagnostic Radiology Physician
MD21428MEMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Aroostook Medical Center CurrentSince Jul 31, 2019 Accepting new patients
Lucidsolutions, Inc. Diagnostic Radiology CurrentSince Mar 5, 2024 Accepting new patients
The Aroostook Medical Center CurrentSince Jul 31, 2019 Accepting new patients
Montgomery-Community Magnetic Imaging CNTR LTD Partnership Diagnostic Radiology Past Accepting new patients
Community Radiology Associates Inc Diagnostic Radiology Past Accepting new patients
DRS Korsower & Pion Radiology PA Diagnostic Radiology Past Accepting new patients
American Radiology Associates, P.a. Diagnostic Radiology Past Accepting new patients
Community Radiology Associates Inc Diagnostic Radiology PastSince Oct 27, 2024 Accepting new patients

Locations

140 Academy St
Presque Isle, ME 04769
Phone (207) 768-4000

140 Academy St
#10
Presque Isle, ME 04769
Phone (207) 764-3734

140 Academy St
Ste 10
Presque Isle, ME 04769
Phone (207) 764-3734

Organizations & group practices 8

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778025600000",
    "number": "1417921842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 EVERETT DOW DR",
            "city": "WOOLWICH",
            "state": "ME",
            "postal_code": "045794571",
            "telephone_number": "207-730-0954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 ACADEMY ST",
            "city": "PRESQUE ISLE",
            "state": "ME",
            "postal_code": "047693102",
            "telephone_number": "207-768-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22 Roulston Rd",
            "address_purpose": "LOCATION",
            "city": "Windham",
            "state": "NH",
            "postal_code": "030871209",
            "country_code": "US",
            "telephone_number": "855-301-0563",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GEORGIA",
        "first_name": "JEFFREY",
        "middle_name": "DAVENPORT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036.177198",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ME",
            "license": "MD21428",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Presque Isle, ME

Sources for this page

Verify at the official NPI Registry.