Jacqueline Marie Davenport, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

6436 Issued in SC

Practice address

200 Patewood Dr
Ste C250
Greenville, SC 29615-3593

Phone

(864) 454-0952

NPI assigned

Aug 19, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jacqueline Marie Delgiorno Former name

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

87.01 of 100Reported as group

Quality

90

Improvement activities

40

Cost

75.04

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Greenville Proaxis Therapy, LLC

  dba ATI Physical Therapy of Greenville

  • Physical Therapist
  • Greenville, SC
  • NPI 1669457859
  Medicare reassignment
• Prisma Health University Medical Group

  • Family Medicine Physician
  • Greenville, SC
  • NPI 1295763217
  NPD (past)
• Ati Holdings of Alabama, LLC

  dba ATI Physical Therapy

  • Physical Therapist
  • Lincoln, AL
  • NPI 1063952646
  NPD (past)

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

{
    "created_epoch": "1313712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507852800000",
    "number": "1811277098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 N MAIN ST",
            "address_2": "STE 300",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012796",
            "telephone_number": "864-528-5700",
            "fax_number": "864-528-5701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PATEWOOD DR",
            "address_2": "STE C250",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296153593",
            "telephone_number": "864-454-0952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "JACQUELINE",
        "middle_name": "MARIE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-19",
        "last_updated": "2017-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "6436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "DELGIORNO",
            "middle_name": "MARIE",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Krystal Davaine, RBT
• Darien Brian Davda, MD
• Allyssa Davenport, RBT
• Andrew Davenport
• Barbara Helen Davenport, CNM
• Jake Joyner Davenport, M.D.
• Kaitlyn Davenport
• Kimberley Davenport, MD
• Megan Renee Davenport, PHARMD
• Glen G Daves, M.D.

• Physical Therapist in Greenville, SC
• Providers in Greenville, SC by specialty
• Physical Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (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.