Active NPI
Jennifer Wu Davenport, M.D.
- Emergency Medicine Physician
- Birmingham, AL
National Provider Identifier
1699065094
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- MD.32083
- Practice address
- 619 19TH St S
Birmingham, AL 35249-1900 - Phone
- (205) 934-5004
- NPI assigned
- Apr 19, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | MD.32083 | AL | Primary |
| Pediatrics Physician | 208000000X | MD.32083 | AL |
Addresses
Primary practice location
619 19TH St S
Birmingham, AL 35249-1900
Mailing address
619 19TH St S
Birmingham, AL 35249-1900
Phone (205) 934-5004
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 015136700 | Medicaid | FL | |
| 511-49576 | Other | AL | BCBS |
| 161321 | Medicaid | AL | |
| 511-49577 | Other | AL | BCBS |
| 162334 | Medicaid | AL |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD.32083 | AL | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1451260800000",
"number": "1699065094",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "619 19TH ST S",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352491900",
"telephone_number": "205-934-5004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "619 19TH ST S",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352491900",
"telephone_number": "205-934-5004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVENPORT",
"first_name": "JENNIFER",
"middle_name": "WU",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-19",
"last_updated": "2015-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "AL",
"license": "MD.32083",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "AL",
"license": "MD.32083",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "015136700",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "511-49576",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "161321",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "511-49577",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "162334",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Birmingham, AL
- Brock Jackson Daughtry, DO
- Charles Steven Daughtry, D. M. D.
- Aditi Ashishkumar Dave, MD
- Barry Davenport, LICSW
- Celia Williams Davenport, D.M.D.
- Kelsey Alexene Davenport
- Susan Elizabeth Davenport, CRNP
- David a Skier MD Facs PC
- David Ashley Oral & Maxillofacial Surgery
- David J Angwin Therapy Services Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.