Alexis Ann Davenport, MD
Individual provider Active NPI Diagnostic Radiology Physician · Detroit, MI
NPI 1457713620 · NPPES record last updated May 26, 2022
Key facts
- NPI
- 1457713620
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- License
- 4301506614 (MI)
- Practice address
- 2799 W Grand Blvd
C/O Henry Ford Hospital, Medical Education Department
Detroit, MI 48202-2608 - Phone
- (313) 916-2600
- NPI assigned
- Mar 25, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Diagnostic Radiology
- Education
- Wayne State University School of Medicine, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Henry Ford Health System
Practice addresses (Care Compare)
2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600
Hospital & facility affiliations
- Henry Ford Health West Bloomfield Hospital
- Henry Ford Health Hospital
- Henry Ford Macomb Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220527001216 | MI | Practitioner - Diagnostic Radiology | 2466744495 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Henry Ford Health System | Diagnostic Radiology | Current |
Accepting new patients |
| Henry Ford Health System | Current |
Accepting new patients | |
| Henry Ford Health System | Current | Accepting new patients | |
| Henry Ford Pathology | Current | Accepting new patients |
Locations
2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062
1 Ford Pl
Ste 3A
Detroit, MI 48202
Phone (313) 874-2892
6777 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 325-1000
Interoperability endpoints
- aburch284443@direct.hfhs.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Diagnostic Radiology Physician | 2085R0202X | 4301506614 | MI | Yes |
Addresses
Primary practice location
2799 W Grand Blvd
C/O Henry Ford Hospital, Medical Education Department
Detroit, MI 48202-2608
Mailing address
2799 W Grand Blvd
C/O Henry Ford Hospital, Medical Education Department
Detroit, MI 48202-2608
Phone (313) 916-2600
Other providers in Detroit, MI
- Rushil Ashwin Dave
- Stephen Dave
- Latonya Marie Davemport
- Davenport Landscaping LLC
- Davenport Quality Home Care LLC
- Andrea Davenport
- Jacob Davenport
- Jordan Davenport
- Laveta Davenport
- Sherron Linda Davenport
All providers in Detroit, MI · Diagnostic Radiology Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 26, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.