Myrtle Howard Davenport, NP-C, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN219619 Issued in GA

Practice address

831 Fairways CT
Ste #1
Stockbridge, GA 30281

Phone

(404) 861-0827

NPI assigned

Aug 9, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Myrtle Davenport Healthcare Services LLC

  • Psychiatry Physician
  • Fayetteville, GA
  • NPI 1942085832
  NPD Authorized official
• Transit Home Care Consultants, LLC

  • Primary Care Nurse Practitioner
  • Atlanta, GA
  • NPI 1548843006
  NPD

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

{
    "created_epoch": "1502236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696723200000",
    "number": "1710402979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 DANNON VW SW",
            "address_2": "STE 3103",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303312158",
            "telephone_number": "404-549-9471",
            "fax_number": "404-549-9486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "831 FAIRWAYS CT",
            "address_2": "STE #1",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "30281",
            "telephone_number": "404-861-0827"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Oxford Ln",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "GA",
            "postal_code": "302155317",
            "country_code": "US",
            "telephone_number": "404-861-0827",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8058 Kylie Ct",
            "address_purpose": "LOCATION",
            "city": "Riverdale",
            "state": "GA",
            "postal_code": "302743985",
            "country_code": "US",
            "telephone_number": "404-861-0827",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "MYRTLE",
        "middle_name": "HOWARD",
        "name_prefix": "Mrs.",
        "credential": "NP-C, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-09",
        "last_updated": "2023-10-08",
        "certification_date": "2023-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "GA",
            "license": "RN219619",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN219619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Randolph Charles Daniel, DDS
• Danielle L Luckett
• Kabir Kumar Das, MD
• Nicholas J Dasta, DC
• Vernice M Dauphin, STUDENT
• David S. Bryant
• Amanda Ruth Davis, DC,
• Angela Denise Davis, LPC
• Arielle Davis
• Erin Mishay Davis, M.A. ED. CCC-SLP

• Psychiatric/Mental Health Nurse Practitioner in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.