Craig R Davenport, M.D.
Individual provider Active NPI Family Medicine Physician · Keokuk, IA
NPI 1508064932 · NPPES record last updated Feb 18, 2025
Key facts
- NPI
- 1508064932
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 38201 (IA)
- Practice address
- 1603 Morgan St Ste 3
Keokuk, IA 52632-3433 - Phone
- (319) 524-4300
- Fax
- (319) 524-4424
- NPI assigned
- Jul 6, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 20
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Quincy Physicians and Surgeons Clinic, PLLC
Practice addresses (Care Compare)
1603 Morgan St
Keokuk, IA 52632-3433
Phone (319) 524-4300
Hospital & facility affiliations
- Lee County Health Department
- Southeast Iowa Regional Medical Center
- Memorial Hospital
- Blessing Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
- 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 |
|---|---|---|---|---|
| I20100603000533 | IA | Practitioner - Family Practice | 6204965049 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38201 | IA | MD | Family Medicine Physician |
| R-8205 | IA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Quincy Physicians & Surgeons Clinic, PLLC | Current |
Accepting new patients | |
| St Luke'S Methodist Hospital | Current | Accepting new patients | |
| Quincy Physicians & Surgeons Clinic, PLLC | Past | Accepting new patients |
Locations
1026 A Ave NE
Cedar Rapids, IA 52402
Phone (319) 369-5970
1600 Morgan St
Keokuk, IA 52632
Phone (319) 524-7150
1603 Morgan St
Ste 3
Keokuk, IA 52632
Phone (319) 524-3796
1025 Maine St
Quincy, IL 62301
Phone 21722265503163
Interoperability endpoints
- cdavenport40471@direct.unitypoint.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 38201 | IA | Yes |
| Family Medicine Physician | 207Q00000X | R-8205 | IA | |
| Family Medicine Physician | 207Q00000X | 036135436 | IL |
Addresses
Primary practice location
1603 Morgan St Ste 3
Keokuk, IA 52632-3433
Mailing address
1603 Morgan St Ste 3
Keokuk, IA 52632-3433
Phone (319) 524-4300
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508064932 | Medicaid | IA |
Other providers in Keokuk, IA
- Counseling Associates, Inc
- Heather Jo Curtis
- Nick John Daskalos
- Dave'S Place
- Dave'S Place LLC
- Amanda Day
- Alyssa Hope Devericks
- Kelsey Dickens
- Thomas Edward Dittmer
- Juliann Finnegan Dorothy
All providers in Keokuk, IA · Family Medicine Physician in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 18, 2025. 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.