Grace Davenport

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

40QA00529300 Issued in NJ

Practice address

600 Medical Center Dr
Sewell, NJ 08080-2361

Phone

(856) 582-8700

NPI assigned

May 26, 2006

Last updated

Feb 20, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Regional Orthopedic Professional Association

  • Orthopaedic Surgery Physician
  • Cherry Hill, NJ
  • NPI 1073567095

  Orthopedic

  NPD (past)

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613779200000",
    "number": "1649226010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 AZALEA DR",
            "city": "DEPTFORD",
            "state": "NJ",
            "postal_code": "080966637",
            "telephone_number": "609-220-5044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MEDICAL CENTER DR",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080802361",
            "telephone_number": "856-582-8700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1871 Route 70 E",
            "address_purpose": "LOCATION",
            "city": "Cherry Hill",
            "state": "NJ",
            "postal_code": "080032020",
            "country_code": "US",
            "telephone_number": "856-424-4240",
            "fax_number": "856-424-3824",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "GRACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2021-02-20",
        "certification_date": "2021-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NJ",
            "license": "40QA00529300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "QA05293",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Ann Danovich, MS, OTR/L
• Yvonne Dansoa, D.O.
• Abbe Dantzig, OT
• Edward Jude Danzi, N.C.M.T
• Tanya M Dargusch, ATC/LAT
• David M. Ringel, DO PA
• Cynthia Lynn Davidson, LCSW
• Bryan F Davis, D.O.
• Sarah Davis, M.D.
• Mae N Dechristy

• Orthopedic Physical Therapist in Sewell, NJ
• Providers in Sewell, NJ by specialty
• Orthopedic Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2021; 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.