Active NPI
Chris Eric Davenport, M.D.
- Family Medicine Physician
- Yorba Linda, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- A117513
- Practice address
- 4300 Rose Dr
Yorba Linda, CA 92886-2026 - Phone
- (714) 528-4211
- Fax
- (714) 579-6868
- NPI assigned
- Jul 27, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A117513 | CA | Primary |
Addresses
Primary practice location
4300 Rose Dr
Yorba Linda, CA 92886-2026
Mailing address
4300 Rose Dr
Yorba Linda, CA 92886-2026
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | cdavenport1043952@oc.providencedirect.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1514 Valley Vista Dr
Diamond Bar, CA 91765-3929
Phone (909) 860-1144
Hospital & facility affiliations
- Providence at Home With Compassus Home Health Orange County
- Providence at Home With Compassus Home Health, Orange County South
- Providence Home Health Inland Empire
- Providence St. Jude Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 117513 | CA | MD | Driver |
| A117513 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Medical Foundation | Multi-Specialty | Current | Accepting new patients |
| St Jude Hospital Inc | Past | Accepting new patients |
Locations
200 W Ctr St Promenade
Ste 400
Anaheim, CA 92805
1514 Valley Vista Dr
Diamond Bar, CA 91765
Phone (909) 560-1144
2251 N Harbor Blvd
Fullerton, CA 92835
Phone (714) 449-6230
1835 Sunny Crest Dr
Fullerton, CA 92835
Phone (714) 446-5101
100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200
2151 N Harbor Blvd
Ste 3200
Fullerton, CA 92835
Phone (714) 446-5101
4300 Rose Dr
Yorba Linda, CA 92886
Phone (714) 528-4211
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- cdavenport1043952@oc.providencedirect.org
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Acute Care Hospital
- Fullerton, CA
- NPI 1194926279
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Anaheim, CA
- NPI 1588486716
-
- Home Health Agency
- Irvine, CA
- NPI 1396567533
-
- General Acute Care Hospital
- Fullerton, CA
- NPI 1194926279
-
- General Acute Care Hospital
- Brea, CA
- NPI 1891904942
-
- Home Health Agency
- Walnut, CA
- NPI 1356706329
-
- Home Health Agency
- Pomona, CA
- NPI 1649475948
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634774400000",
"number": "1639300528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4300 ROSE DR",
"city": "YORBA LINDA",
"state": "CA",
"postal_code": "928862026"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4300 ROSE DR",
"city": "YORBA LINDA",
"state": "CA",
"postal_code": "928862026",
"telephone_number": "714-528-4211",
"fax_number": "714-579-6868"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVENPORT",
"first_name": "CHRIS",
"middle_name": "ERIC",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-07-27",
"last_updated": "2021-10-21",
"certification_date": "2021-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "CA",
"license": "A117513",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "cdavenport1043952@oc.providencedirect.org",
"affiliation": "N",
"address_1": "1835 Sunny Crest Dr",
"city": "Fullerton",
"state": "CA",
"country_code": "US",
"postal_code": "928353616",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Yorba Linda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.