Keriann Davenport, M.A., BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-23-65012 Issued in IN

Practice address

5719 S Madison Ave
Anderson, IN 46013-1651

Phone

(765) 606-4995

NPI assigned

Apr 10, 2023

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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 and National Provider Directory roles.

• The Growing Place

  • Behavior Analyst
  • Anderson, IN
  • NPI 1598533218
  NPD

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

{
    "created_epoch": "1681084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681084800000",
    "number": "1457046849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6302 N PARK AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462201740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5719 S MADISON AVE",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460131651",
            "telephone_number": "765-606-4995"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "810 W 53rd St",
            "address_purpose": "LOCATION",
            "city": "Anderson",
            "state": "IN",
            "postal_code": "460131516",
            "country_code": "US",
            "telephone_number": "765-606-4995",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "KERIANN",
        "name_prefix": "Mrs.",
        "credential": "M.A., BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-10",
        "last_updated": "2023-04-10",
        "certification_date": "2023-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IN",
            "license": "1-23-65012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Daniel
• Joseph Daoko, M.D
• Valerie Darling, LMHC
• Bibhuti Bhusan Das, MD
• Caryn Davenport
• Larry C Davenport, LMHC
• Rachel Marie Davenport, M.D.
• David C. Gephardt D.D.S.,P.C.
• David L. Martin, M.D., Inc
• Blanca R David, MD

• Behavior Analyst in Anderson, IN
• Providers in Anderson, IN by specialty
• Behavior Analyst in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2023; 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.