Active NPI
William Davenport III, CSFA
- Surgical Assistant
- Fort Payne, AL
National Provider Identifier
1639576408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- License
- 154845
- Practice address
- 2605 Gault Ave N
Fort Payne, AL 35967-3751 - Phone
- (256) 979-1550
- NPI assigned
- Nov 22, 2014
- Last updated
- Nov 19, 2018
- 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 |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | 154845 | GA | Primary |
Addresses
Primary practice location
2605 Gault Ave N
Fort Payne, AL 35967-3751
Mailing address
64 Ginger Lake Drive
Rock Spring, GA 30739-2249
Phone (423) 321-2506
Other practice location 1
200 Medical Center Dr SW
Fort Payne, AL 35968-3458
Phone (256) 854-3150
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 154845 | GA | MD | Surgical Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1416614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1542585600000",
"number": "1639576408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "64 GINGER LAKE DRIVE",
"city": "ROCK SPRING",
"state": "GA",
"postal_code": "307392249",
"telephone_number": "423-321-2506"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2605 GAULT AVE N",
"city": "FORT PAYNE",
"state": "AL",
"postal_code": "359673751",
"telephone_number": "256-979-1550"
}
],
"practiceLocations": [
{
"address_1": "200 Medical Center Dr SW",
"address_purpose": "LOCATION",
"city": "Fort Payne",
"state": "AL",
"postal_code": "359683458",
"country_code": "US",
"telephone_number": "256-854-3150",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DAVENPORT",
"first_name": "WILLIAM",
"name_prefix": "Mr.",
"name_suffix": "III",
"credential": "CSFA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-11-22",
"last_updated": "2018-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "GA",
"license": "154845",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Payne, AL
- Janna Kay Culpepper, CRNP
- Angela Aurora Cunningham, NP-C
- Christa Lillieann Curtis, DC
- Dale R Stierwalt MD PC
- Haley Brooke Dalton, CRNP
- Dekalb Anesthesia Associates, LLC
- Dekalb County Health Dept Adult Immun
- Dekalb County Health Dept AIDS
- Dekalb County Health Dept Child
- Dekalb County Health Dept Epsdt
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.