Individual provider Active NPI

Bianca Marie Davenport, M.D.

  • Neonatal-Perinatal Medicine Physician
  • Houston, TX
National Provider Identifier
1770877979
Registry record updated Mar 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
P9830 Issued in TX
Practice address
7400 Fannin St Ste 810
Houston, TX 77054-1935
Phone
(713) 512-8500
Fax
(713) 796-2121
NPI assigned
Jun 6, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X BP1-0039527 TX
Pediatrics Physician 208000000X P9830 TX
Student in an Organized Health Care Education/Training Program 390200000X
Neonatal-Perinatal Medicine Physician 2080N0001X P9830 TX Primary

Addresses

Primary practice location

7400 Fannin St Ste 810
Houston, TX 77054-1935

Mailing address

4301 W Markham St
Little Rock, AR 72205-7101

Other practice location 1

4301 W Markham St
Little Rock, AR 72205-7101
Phone (501) 686-5356

Other identifiers 2

IdentifierTypeStateIssuer
340903902MedicaidTX
340903901MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200103000804 NV Practitioner - Pediatric Medicine 7719209642 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP1-0039527TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pokroy Medical Group of Nevada, LTD. Pediatrics CurrentSince Nov 1, 2019 Accepting new patients
Spring Valley Medical Center Past Accepting new patients
Summerlin Hospital Medical Center L L C Past Accepting new patients
Centennial Hills Hospital Medical Center Past Accepting new patients
Henderson Hospital Past Accepting new patients

Locations

File 50978
Los Angeles, CA 90074

770 The City Dr S
Ste 4000
Orange, CA 92868
Phone (800) 463-6628

1050 W Galleria Dr
Henderson, NV 89011
Phone (702) 723-4124

3186 S Maryland Pkwy
Las Vegas, NV 89109
Phone (702) 731-8000

5400 S Rainbow Blvd
Las Vegas, NV 89118
Phone (702) 252-7342

657 N Town Center Dr
Las Vegas, NV 89144
Phone (702) 233-7571

6900 N Durango Dr
Las Vegas, NV 89149
Phone (702) 380-1964

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1566/brand/2/csg/41/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1307318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553040000000",
    "number": "1770877979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 FANNIN ST STE 810",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770541935",
            "telephone_number": "713-512-8500",
            "fax_number": "713-796-2121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4301 W Markham St",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722057101",
            "country_code": "US",
            "telephone_number": "501-686-5356",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "BIANCA",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-06",
        "last_updated": "2019-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "BP1-0039527",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "P9830",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "TX",
            "license": "P9830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340903902",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340903901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.