Leamon L. Davenport, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

OS017399 Issued in PA

Practice address

30 Medical Center Blvd
Suite 205
Upland, PA 19013-3955

Phone

(610) 619-7410

Fax

(610) 876-8483

NPI assigned

Mar 24, 2006

Last updated

May 27, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Prospect Health Access Network, Inc.

  • Emergency Medicine Physician
  • Chester, PA
  • NPI 1568819084
  Medicare reassignment NPD
• Prospect Health Access Network, Inc.

  • Diagnostic Radiology Physician
  • Chester, PA
  • NPI 1154776797
  NPD
• Prospect Health Access Network, Inc.

  • Pediatric Adolescent Medicine Physician
  • Chester, PA
  • NPI 1487001996
  NPD

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432684800000",
    "number": "1649230525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 MEDICAL CENTER BLVD",
            "address_2": "SUITE 205",
            "city": "UPLAND",
            "state": "PA",
            "postal_code": "190133955",
            "telephone_number": "610-619-7410",
            "fax_number": "610-876-8483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 MEDICAL CENTER BLVD",
            "address_2": "SUITE 205",
            "city": "UPLAND",
            "state": "PA",
            "postal_code": "190133955",
            "telephone_number": "610-619-7410",
            "fax_number": "610-876-8483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "LEAMON",
        "middle_name": "L.",
        "name_prefix": "Mr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2015-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "MB08546500",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NM",
            "license": "A123303",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "OS017399",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NJ",
            "license": "MB08546500",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807919",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43670083",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Crozer-Chester Medical Center (CrozerTaylorSpringfield)
• Crozer-Chester Medical Center (CrozerTaylorSpringfield)
• Crozer-Chester Medical Center
• Maureen Cuesta, CRNA
• John A. Daller, MD, PHD
• Christina Davidyock, CRNP
• Tina Marie Deangelis, EDE, OTR/L
• Delaware County Urological Associates, LTD
• Sharon T. Denny, M.D.
• Lisa Deppen, CRNA

• Pediatrics Physician in Upland, PA
• Providers in Upland, PA by specialty
• Pediatrics Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.