NPIMap

Individual provider Active NPI

Gary B Davenport, MD

  • Internal Medicine Physician
  • Mill Creek, WV
National Provider Identifier
1720074883
Registry record updated Jul 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
21118 Issued in WV
Practice address
US Routes 219 & 250
Mill Creek, WV 26280-0000
Phone
(304) 335-2050
Fax
(304) 335-6158
NPI assigned
Sep 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 21118 WV Primary

Addresses

Primary practice location

US Routes 219 & 250
Mill Creek, WV 26280-0000

Mailing address

PO Box 247
Mill Creek, WV 26280-0247
Phone (304) 335-2050

Other identifiers 1

IdentifierTypeStateIssuer
3004232000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
21118WVMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Ohio County , PLLC Internal Medicine Past Accepting new patients
Elm Emergency Group PLLC Past Accepting new patients
Hospitalist Medicine Physicians of West Virginia, PLLC Internal Medicine Past Accepting new patients
Camden Clark Memorial Hospital Corporation Past Accepting new patients
Hospitalist Medicine Physicians of Charleston, PLLC Internal Medicine Past Accepting new patients
Hospital Care Consultants Region II Inc Internal Medicine Past Accepting new patients
Hospitalist Medicine Physicians of Wood County, PLLC Internal Medicine Past Accepting new patients
Hospitalist Medicine Physicians of Pennsylvania, P.C. Internal Medicine Past Accepting new patients
Valley Health Care, Inc Past Accepting new patients

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278028800000",
    "number": "1720074883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 247",
            "city": "MILL CREEK",
            "state": "WV",
            "postal_code": "262800247",
            "telephone_number": "304-335-2050",
            "fax_number": "304-335-6158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "US ROUTES 219 & 250",
            "city": "MILL CREEK",
            "state": "WV",
            "postal_code": "262800000",
            "telephone_number": "304-335-2050",
            "fax_number": "304-335-6158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "GARY",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-23",
        "last_updated": "2010-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "21118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3004232000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Creek, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.