Individual provider Active NPI

Mardi L Davenport, N.P.

  • Family Nurse Practitioner
  • Surprise, AZ
National Provider Identifier
1609182583
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP3719 Issued in AZ
Practice address
15474 W Greenway Rd
Surprise, AZ 85374-4348
Phone
(866) 389-2727
NPI assigned
Aug 30, 2010
Last updated
Oct 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP3719 AZ Primary
Nurse Practitioner 363L00000X AP3719 AZ

Addresses

Primary practice location

15474 W Greenway Rd
Surprise, AZ 85374-4348

Mailing address

PO Box 860912
Minneapolis, MN 55486-0912
Phone (480) 301-8000

Other practice location 1

13400 E Shea Blvd
Scottsdale, AZ 85259-5499
Phone (480) 301-8000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mdavenport2545363@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110721000183 AZ Practitioner - Nurse Practitioner 9739357575 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinnacle Family Medicine PLCGroup PAC ID 7012015670, 9 clinicians

Practice addresses (Care Compare)

14044 W Camelback Rd
Suite 204
Litchfield Park, AZ 85340-9426
Phone (623) 935-9600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP3719AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Family Medicine PLC Family Medicine CurrentSince Sep 5, 2023 Accepting new patients
Mayo Clinic Arizona CurrentSince Aug 25, 2025 Accepting new patients
Pinnacle Family Medicine PLC Family Medicine CurrentSince Jan 9, 2018 Accepting new patients
Mayo Clinic Arizona CurrentSince Aug 25, 2025 Accepting new patients

Locations

14044 W Camelback Rd
Ste 204
Litchfield Pk, AZ 85340
Phone (623) 535-5599

21753 N 77th Ave
Peoria, AZ 85382
Phone (623) 935-9600

5777 E Mayo Blvd
Phoenix, AZ 85054
Phone (480) 342-1800

13400 E Shea Blvd
Scottsdale, AZ 85259

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1283126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1609182583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 860912",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554860912",
            "telephone_number": "480-301-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15474 W GREENWAY RD",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853744348",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13400 E Shea Blvd",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852595499",
            "country_code": "US",
            "telephone_number": "480-301-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "MARDI",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-30",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP3719",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP3719",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdavenport2545363@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "13400 E Shea Blvd",
            "city": "Scottsdale",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852595499",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

Verify at the official NPI Registry.