Susan Kinard Davenport

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

604 S Wall St
Shelbyville, TN 37160-3797

Phone

(931) 684-0522

NPI assigned

Feb 21, 2013

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

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.

• Centerstone of Tennessee, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Nashville, TN
  • NPI 1396767430
  NPD
• Centerstone of Tennessee, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Manhattan, KS
  • NPI 1023900651
  NPD (past)

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

{
    "created_epoch": "1361404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1497095848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1921 RANSOM PL",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372173841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 S WALL ST",
            "city": "SHELBYVILLE",
            "state": "TN",
            "postal_code": "371603797",
            "telephone_number": "931-684-0522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "SUSAN",
        "middle_name": "KINARD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-21",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victor Cutillo, DPT
• Cutting Edge Optical, LLC
• Dale Hasty
• Brooke Dangerfield, M.S.
• Jeff Daugherty
• Matthew Gabe Davidson, DO
• Davis Dental, PLLC
• Allison Elizabeth Davis
• Jay Gibson Davis, D.D.S.
• Amber Dawson, RN

• All providers in Shelbyville, TN
• Mental Health Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2020; 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.