Victoria Nicole Davenport – Family Medicine Physician

Key facts

NPI: 1750873170
Entity type: Individual (NPI type 1)
Primary specialty: Family Medicine Physician 207Q00000X
License: DO3241 (ME)
Practice address: 895 Union St Ste 12
Bangor, ME 04401-3054
Phone: (207) 973-7979
Fax: (207) 947-9579
NPI assigned: Jun 1, 2018
Sex: Female
Sole proprietor: No

Organizations & group practices 5

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.

Sebasticook Valley Health Critical Access Hospital · Pittsfield, ME · NPI 1457461477

Medicare reassignment Care Compare group NPD ME
Sebasticook Valley Health Rural Health Clinic/Center · Unity, ME · NPI 1427181486

Care Compare group NPD FAMILY MEDICINE
Sebasticook Valley Health Medicare Defined Swing Bed Hospital Unit · Pittsfield, ME · NPI 1013176544

Care Compare group
Sebasticook Valley Health Rural Health Clinic/Center · Pittsfield, ME · NPI 1063617744

Care Compare group
Sebasticook Valley Health Rural Health Clinic/Center · Newport, ME · NPI 1295367803

Care Compare group

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Sebasticook Valley Health Critical Access Hospital · Pittsfield, ME · NPI 1457461477

Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty: Family Practice
Education: Other, 2018
Medicare assignment: May accept Medicare assignment
Group practices: Sebasticook Valley Health (35 clinicians)

Practice addresses (Care Compare)

447 N Main St
Pittsfield, ME 04967-3707
Phone (207) 487-4000

Hospital & facility affiliations

Northern Light Sebasticook Valley Hospital Hospital · Pittsfield, ME · CCN 201313

Merit-based Incentive Payment System (MIPS)

Final score: 89.98 of 100 (group)
Quality: 74.88
Promoting interoperability: 96
Improvement activities: 40

Medicare participation

Medicare fee-for-service enrollment: Enrolled in ME
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20210802000701	ME	Practitioner - Family Practice	6204184153	Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Osteopathy

Practice roles

Organization	Specialty	Status	New patients
Sebasticook Valley Health	Family Medicine	Current since Sep 4, 2022	Accepting new patients
Sebasticook Valley Health		Current since Sep 4, 2022	Accepting new patients

Locations

489 State St
Bangor, ME 04401
Phone (207) 973-8837

447 N Main St
Pittsfield, ME 04967
Phone (207) 487-0981

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Student in an Organized Health Care Education/Training Program	390200000X
Family Medicine Physician	207Q00000X	DO3241	ME	Yes

Addresses

Primary practice location

895 Union St Ste 12
Bangor, ME 04401-3054

Mailing address

43 Whiting Hill Rd Ste 300
Brewer, ME 04412-1006
Phone (207) 973-5000

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 30, 2021.

{
    "created_epoch": "1527811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627603200000",
    "number": "1750873170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 WHITING HILL RD STE 300",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044121006",
            "telephone_number": "207-973-5000",
            "fax_number": "207-973-5042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "895 UNION ST STE 12",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013054",
            "telephone_number": "207-973-7979",
            "fax_number": "207-947-9579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "VICTORIA",
        "middle_name": "NICOLE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-01",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "DO3241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

All providers in Bangor, ME · Family Medicine Physician in Maine

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 30, 2021. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
Medicare Care Compare provider data (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.