Individual provider Active NPI

Laura Beth Davenport, FNP-C

  • Nurse Practitioner
  • Tyler, TX
National Provider Identifier
1679944946
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP129297 Issued in TX
Practice address
520 Douglas Blvd
Tyler, TX 75702-8307
Phone
(903) 593-1721
NPI assigned
Oct 13, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP129297 TX Primary

Addresses

Primary practice location

520 Douglas Blvd
Tyler, TX 75702-8307

Mailing address

PO Box 846098
Dallas, TX 75284-6098
Phone (903) 324-6400

Other practice location 1

619 S Fleishel Ave Ste 327
Tyler, TX 75701-2019
Phone (903) 606-1400

Other identifiers 23

IdentifierTypeStateIssuer
75-2616977-007OtherTXTRICARE
8343NSOtherTXBCBS
352819204MedicaidTX
75-0818167-015OtherTXTRICARE
850NYOtherTXBCBS
75-2616977-129OtherTXTRICARE
8478NYOtherTXBCBS
352819201MedicaidTX
75-0818167-048OtherTXTRICARE
75-2616977-028OtherTXTR
P01707526OtherTXRAIL ROAD MEDICARE
352819202MedicaidTX
352819203MedicaidTX
75-2616977-002OtherTXTRICARE
75-2616977-118OtherTXTRICARE
75-0818167-022OtherTXTRICARE
75-0818167-044OtherTXTRICARE
75-1976930-005OtherTXTRICARE
75-2616977-023OtherTXTRIUCARE
P01569953OtherTXRAIL ROAD MEDICARE
75-2616977-001OtherTXTRICARE
8946NYOtherTXBCBS
P01707529OtherTXRAIL ROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151111001205 TX Practitioner - Nurse Practitioner 3577873165 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

520 Douglas Blvd
Tyler, TX 75702-8307
Phone (903) 593-1721

620 S Fleishel Ave
Christus Trinity Clinic
Tyler, TX 75701-2041
Phone (903) 606-4900

630 S Fleishel Ave
Tyler, TX 75701-2041
Phone (903) 606-5560

PO Box
Suite 846098
Dallas, TX 75284-6098

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mother Frances Hospital Jacksonville CurrentSince Jul 27, 2016 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Oct 19, 2015 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Oct 19, 2015 Accepting new patients
Mother Frances Hospital Regional Health Care Center CurrentSince Aug 27, 2016 Accepting new patients

Locations

2026 S Jackson St
Jacksonville, TX 75766
Phone (903) 541-4500

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

619 S Fleishel Ave
Ste 327
Tyler, TX 75701
Phone (903) 510-1173

520 Douglas Blvd
Tyler, TX 75702
Phone (903) 510-1175

800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018

Interoperability endpoints

  • Direct secure messaging: ldavenport70021@christushealth.direct-ci.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
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    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758240000000",
    "number": "1679944946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 846098",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752846098",
            "telephone_number": "903-324-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 DOUGLAS BLVD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757028307",
            "telephone_number": "903-593-1721"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "619 S Fleishel Ave Ste 327",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757012019",
            "country_code": "US",
            "telephone_number": "903-606-1400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "LAURA",
        "middle_name": "BETH",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-13",
        "last_updated": "2025-09-19",
        "certification_date": "2025-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP129297",
            "primary": true
        }
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        {
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        {
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            "desc": "MEDICAID",
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            "identifier": "352819202",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "352819203",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-2616977-002",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-2616977-118",
            "state": "TX"
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        {
            "code": "01",
            "desc": "Other (non-Medicare)",
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        {
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            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-0818167-044",
            "state": "TX"
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        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-1976930-005",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIUCARE",
            "identifier": "75-2616977-023",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P01569953",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "75-2616977-001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8946NY",
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        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P01707529",
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        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.