Active NPI
Deborah Davenport, M.D.
- Obstetrics & Gynecology Physician
- East Setauket, NY
National Provider Identifier
1679659346
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 136738
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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.