Jack Adam Davenport, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

121287 Issued in IA

Practice address

1200 Pleasant St
Des Moines, IA 50309-1406

Phone

(515) 241-6372

NPI assigned

Sep 27, 2013

Last updated

Jun 26, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Associated Anesthesiologists PCGroup PAC ID 9638068307, 65 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Unitypoint Health - Des Moines Iowa Methodist Medi Hospital, Des Moines, IA, CCN 160082

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

Practice roles

Interoperability endpoints

• Direct secure messaging: jdavenport158033@direct.unitypoint.org

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.

• Associated Anesthesiologists, P.C.

  • Anesthesiology Physician
  • Des Moines, IA
  • NPI 1215904750
  Medicare reassignment Care Compare group
• St Luke's Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD

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

• Central Iowa Hospital Corporation

  dba Iowa Lutheran Hospital

  • General Acute Care Hospital
  • Des Moines, IA
  • NPI 1356433049
  Care Compare affiliation
• Central Iowa Hospital Corporation

  dba Iowa Methodist Medical Center

  • General Acute Care Hospital
  • Des Moines, IA
  • NPI 1396837951
  Care Compare affiliation
• Central Iowa Hospital Corporation

  dba Iowa Methodist Medical Center-Methodist West

  • General Acute Care Hospital
  • West Des Moines, IA
  • NPI 1598905762
  Care Compare affiliation

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

{
    "created_epoch": "1380240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1699102301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 WESTOWN PKWY STE 236",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502666720",
            "telephone_number": "515-401-1950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 PLEASANT ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503091406",
            "telephone_number": "515-241-6372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "JACK",
        "middle_name": "ADAM",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-27",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IA",
            "license": "121287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dartmed LLC
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• Daniel Daskalakis, DO
• Tamara Manoji Dassanayake, M.D.
• Elizabeth Ashley Daubner, ARNP
• Thomas R Davey
• Erin Pazaski Davick, MD
• Stephen Davick, MD
• David a. Yount DPM, PC (advanced foot & ankle clinic)
• David E Drake DO PC

• Certified Registered Nurse Anesthetist in Des Moines, IA
• Providers in Des Moines, IA by specialty
• Certified Registered Nurse Anesthetist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.