David Ross Davenport Jr., PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

C50000498 Issued in DE

Practice address

1275 S State St
Dover, DE 19901-6927

Phone

(302) 678-1303

NPI assigned

Jul 26, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bayhealth Medical Center, Inc.

  dba Medical Alternative Care

  • Clinic/Center
  • Milford, DE
  • NPI 1265422828
  NPD (past)
• Modern Maturity Center

  • Adult Day Care Clinic/Center
  • Dover, DE
  • NPI 1609923408
  NPD (past)

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1518981539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "193 WYCOMBE DR",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199043862",
            "telephone_number": "302-678-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 S STATE ST",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199016927",
            "telephone_number": "302-678-1303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "DAVID",
        "middle_name": "ROSS",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": "C50000498",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "DE",
            "license": "C5-0000498",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lena Das, M.D.
• Danielle Dash, LPCMH
• Diana Maria Dasilva, FNP-BC
• Carla Daufenbach, L.C.S.W.
• Bhavin R Dave, MD
• David E. Schmidt Jr., M.D.P.a.
• Nedra Tenley Davidson
• Svastijaya Daviratanasilpa, M.D.
• Carla Davis-Mann
• Emerald Davis

• Physician Assistant in Dover, DE
• Providers in Dover, DE by specialty
• Physician Assistant in Delaware

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