NPIMap

Organization Active NPI

Davenport Pediatrics Clermont, P.a.

  • Pediatric Adolescent Medicine Physician
  • Clermont, FL
National Provider Identifier
1700021508
Registry record updated Jul 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
Legal business name
DAVENPORT PEDIATRICS CLERMONT, P.A.
Practice address
1528 Sunrise Plaza Dr Ste 1
Clermont, FL 34714-6203
Phone
(352) 394-7728
Fax
(352) 394-6369
NPI assigned
Dec 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2011

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

Authorized official

Name
Dr. Jamil H Khan, M.D.NPI 1861577694
Title
Physician
Phone
(352) 394-7728

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080A0000X Primary

Addresses

Primary practice location

1528 Sunrise Plaza Dr Ste 1
Clermont, FL 34714-6203

Mailing address

1528 Sunrise Plaza Dr Ste 1
Clermont, FL 34714-6203
Phone (352) 394-7728

National Provider Directory

National Provider Directory

Locations

1528 Sunrise Plaza Dr
Ste 1
Clermont, FL 34714
Phone (352) 394-7728

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1228694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310947200000",
    "number": "1700021508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1528 SUNRISE PLAZA DR STE 1",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347146203",
            "telephone_number": "352-394-7728",
            "fax_number": "352-394-6369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1528 SUNRISE PLAZA DR STE 1",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347146203",
            "telephone_number": "352-394-7728",
            "fax_number": "352-394-6369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVENPORT PEDIATRICS CLERMONT, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-08",
        "last_updated": "2011-07-18",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "JAMIL",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "352-394-7728",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2011; 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.