Individual provider Active NPI

David E Davenport, MD

  • Radiation Oncology Physician
  • Spokane Valley, WA
National Provider Identifier
1558353052
Registry record updated Mar 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
M5335 Issued in ID
Practice address
1204 N Vercler Rd
Ste 101
Spokane Valley, WA 99216-1020
Phone
(509) 228-1000
Fax
(509) 252-9300
NPI assigned
Aug 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X M5335 ID Primary

Addresses

Primary practice location

1204 N Vercler Rd
Ste 101
Spokane Valley, WA 99216-1020

Mailing address

PO Box 3868
Spokane, WA 99220-3868
Phone (509) 228-1000

Other identifiers 2

IdentifierTypeStateIssuer
003666600MedicaidID
320000487OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M5335IDMDRadiation Oncology Physician

Interoperability endpoints

  • Direct secure messaging: ddavenport350783@direct.multicare.org

NPI Registry JSON

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490572800000",
    "number": "1558353052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3868",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992203868",
            "telephone_number": "509-228-1000",
            "fax_number": "509-252-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 N VERCLER RD",
            "address_2": "STE 101",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992161020",
            "telephone_number": "509-228-1000",
            "fax_number": "509-252-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "DAVID",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-19",
        "last_updated": "2017-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "ID",
            "license": "M5335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003666600",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "320000487",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane Valley, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2017; 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.