Deborah A Davenport, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

30600 Issued in MN

Practice address

3625 W 65TH St
Suite 100
Edina, MN 55435-2106

Phone

(952) 920-7001

Fax

(952) 920-2245

NPI assigned

Aug 8, 2006

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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Premier OBGYN of Minnesota PLLC

  • Obstetrics & Gynecology Physician
  • Edina, MN
  • NPI 1801946223
  Medicare reassignment NPD

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316044800000",
    "number": "1497765044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3625 W 65TH ST",
            "address_2": "SUITE 100",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352106",
            "telephone_number": "952-920-7001",
            "fax_number": "952-920-2245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 W 65TH ST",
            "address_2": "SUITE 100",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352106",
            "telephone_number": "952-920-7001",
            "fax_number": "952-920-2245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "DEBORAH",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2011-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MN",
            "license": "30600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "619393500",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "0716969",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "19225DA",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barbara Darsow, COTH/L
• Paul Dayan Dasari, MD
• Christy R Dauner, O.T.
• Ana Rae Dauschmidt, PA-C
• Ketan Davae, MD
• David Adson MD LLC
• David J Elasky DDS PA
• Miriam David
• Patricia Mary Davids, MA LP LMFT
• John Brandon Davies, MD

• Obstetrics & Gynecology Physician in Edina, MN
• Providers in Edina, MN by specialty
• Obstetrics & Gynecology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.