Lottie S Davenport, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Jasper, GA
NPI 1629048756 · NPPES record last updated Oct 14, 2025
Key facts
- NPI
- 1629048756
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- RN149848 (GA)
- Practice address
- 51 Gordon Rd Ste 201
Jasper, GA 30143-7104 - Phone
- (706) 692-9768
- NPI assigned
- Jan 23, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060717000111 | GA | Practitioner - Nurse Practitioner | 4981617909 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Internal Medicine Associates of Jasper, PC | Current |
Accepting new patients | |
| HMV Diagnostics | Current |
Accepting new patients | |
| Immediate Medcare of Ellijay, LLC | Past | Accepting new patients | |
| Immediate Medcare, LLC | Past | Accepting new patients | |
| Piedmont Medical Care Corporation | Past |
Accepting new patients |
Locations
5304 Mile Stretch Dr
Holiday, FL 34690
Phone (727) 940-5908
3475 Lenox Rd NE
Ste 400
Atlanta, GA 30326
Phone (404) 601-2394
684 Sixes Rd
Ste 105
Holly Springs, GA 30115
Phone (678) 388-5170
51 Gordon Rd
#201
Jasper, GA 30143
51 Gordon Rd
Ste 201
Jasper, GA 30143
Phone 70669297684002
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN149848 | GA | Yes |
Addresses
Primary practice location
51 Gordon Rd Ste 201
Jasper, GA 30143-7104
Mailing address
51 Gordon Rd Ste 201
Jasper, GA 30143-7104
Phone (706) 692-9768
Other providers in Jasper, GA
- Nicholas B Cummings
- Emily S Cummins
- Steven Eugene Curry
- Melanie Ann Dallas
- Rose A Darby
- David Barron and Associates LLC
- Jema Day
- Katherine De la Croix
- Daniel Dean
- Denton Family Clinic LLC
All providers in Jasper, GA · Family Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 14, 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.