NPIMap

Organization Active NPI

M Patrick Davenport Appc

  • Psychologist
  • Shreveport, LA
National Provider Identifier
1730487844
Registry record updated May 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
464 Issued in LA
Legal business name
M PATRICK DAVENPORT APPC
Practice address
1002 Highland Ave
3Rd Floor
Shreveport, LA 71101-4143
Phone
(318) 222-6226
Fax
(318) 222-6227
NPI assigned
Mar 14, 2011
Last updated
May 10, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2011

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

Authorized official

Name
Dr. Michael Patrick Davenport, PHDNPI 1659308104
Title
Owner
Phone
(318) 518-5001

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 464 LA Primary

Addresses

Primary practice location

1002 Highland Ave
3Rd Floor
Shreveport, LA 71101-4143

Mailing address

1002 Highland Ave
2ND Floor
Shreveport, LA 71101-4143
Phone (318) 222-6226

National Provider Directory

National Provider Directory

Locations

1002 Highland Ave
Fl 2
Shreveport, LA 71101
Phone (318) 222-6226

1002 Highland Ave
Fl 3
Shreveport, LA 71101
Phone (318) 222-6226

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1300060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304985600000",
    "number": "1730487844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 HIGHLAND AVE",
            "address_2": "2ND FLOOR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014143",
            "telephone_number": "318-222-6226",
            "fax_number": "318-222-6227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 HIGHLAND AVE",
            "address_2": "3RD FLOOR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014143",
            "telephone_number": "318-222-6226",
            "fax_number": "318-222-6227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M PATRICK DAVENPORT APPC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-14",
        "last_updated": "2011-05-10",
        "status": "A",
        "authorized_official_last_name": "DAVENPORT",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-518-5001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "LA",
            "license": "464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 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.