Active NPI
Robert Carlton Davenport, MD
- Family Medicine Physician
- Pittsfield, MA
National Provider Identifier
1811089451
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 137462
- Practice address
- 631B North Street
Pittsfield, MA 01201-4109 - Phone
- (413) 499-2054
- Fax
- (413) 445-9174
- NPI assigned
- Sep 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 137462 | NY | Primary |
Addresses
Primary practice location
631B North Street
Pittsfield, MA 01201-4109
Mailing address
725 North St
Pittsfield, MA 01201-4109
Phone (413) 881-5427
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 137462 | NY | MD | Family Medicine Physician |
Interoperability endpoints
- robert.davenport.1@13063.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383091200000",
"number": "1811089451",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "725 NORTH ST",
"city": "PITTSFIELD",
"state": "MA",
"postal_code": "012014109",
"telephone_number": "413-881-5427",
"fax_number": "413-496-6836"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "631B NORTH STREET",
"city": "PITTSFIELD",
"state": "MA",
"postal_code": "012014109",
"telephone_number": "413-499-2054",
"fax_number": "413-445-9174"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVENPORT",
"first_name": "ROBERT",
"middle_name": "CARLTON",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-29",
"last_updated": "2013-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NY",
"license": "137462",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pittsfield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.