Charlisa Davenport

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

C-APN.0003579-C-NP Issued in CO

Practice address

3095 Wilson CT
Denver, CO 80205-4945

Phone

(303) 803-5726

NPI assigned

Feb 10, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Charlisa Brown Former name

Medicare fee-for-service enrollment

Enrolled in LA

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: charlisa.davenport.1@32719.direct.athenahealth.com

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.

• David Raines Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Shreveport, LA
  • NPI 1215933254
  Medicare reassignment NPD
• David Raines Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Minden, LA
  • NPI 1265438998
  NPD
• David Raines Community Health Center, Inc

  dba David Raines Community Health Center- Mobile Medical Unit #3

  • Federally Qualified Health Center (FQHC)
  • Shreveport, LA
  • NPI 1205721487
  NPD
• Empower Mental Health & Wellness, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Shreveport, LA
  • NPI 1699434845
  NPD
• Reiff Mental Health LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Denver, CO
  • NPI 1093489759
  NPD (past)

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

{
    "created_epoch": "1455062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1740648344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7505 BEEBE DR",
            "city": "GREENWOOD",
            "state": "LA",
            "postal_code": "710333313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3095 WILSON CT",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802054945",
            "telephone_number": "303-803-5726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "CHARLISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-10",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "LA",
            "license": "147386",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "1636968",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "LA",
            "license": "208625",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "C-APN.0003579-C-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARLISA",
            "last_name": "BROWN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Barbara Marie Dausch, PH.D.
• Jennifer Lynn Dautricourt, CNA
• Nadyne Davalos, RN, CAC III
• Andrew David Davalt, PAC
• Adam Dave, M.D.
• Kristen Davenport, RN, BSN, OCN
• Charlene Ann Davey, FNP-MSN
• Maggie Davey
• David Bryant DDS PLLC (South Shore Dental)
• David C Forschner MD PC (Rocky Mountain Women's Care PC)

• Psychiatric/Mental Health Nurse Practitioner in Denver, CO
• Providers in Denver, CO by specialty
• Psychiatric/Mental Health Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 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; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.