Individual provider Active NPI

Deborah Davenport, M.D.

  • Obstetrics & Gynecology Physician
  • East Setauket, NY
National Provider Identifier
1679659346
Registry record updated Dec 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
136738 Issued in NY
Practice address
100 S Jersey Ave Unit 16
East Setauket, NY 11733-2036
Phone
(631) 689-6400
NPI assigned
Oct 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 136738 NY
Obstetrics Physician 207VX0000X 136738 NY
Obstetrics & Gynecology Physician 207V00000X 136738 NY Primary

Addresses

Primary practice location

100 S Jersey Ave Unit 16
East Setauket, NY 11733-2036

Mailing address

900 Merchants Concourse Ste 216
Westbury, NY 11590-5114
Phone (516) 226-8373

Other practice location 1

285 Sills Rd Ste D
East Patchogue, NY 11772-4869
Phone (631) 447-1032

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
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575331200000",
    "number": "1679659346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 MERCHANTS CONCOURSE STE 216",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115905114",
            "telephone_number": "516-226-8373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S JERSEY AVE UNIT 16",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117332036",
            "telephone_number": "631-689-6400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "285 Sills Rd Ste D",
            "address_purpose": "LOCATION",
            "city": "East Patchogue",
            "state": "NY",
            "postal_code": "117724869",
            "country_code": "US",
            "telephone_number": "631-447-1032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "DEBORAH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2019-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NY",
            "license": "136738",
            "primary": false
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "NY",
            "license": "136738",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "136738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Setauket, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2019; 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.