Richard D Davenport, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

19876 Issued in WI

Practice address

2424 S 90TH St
Ste 506
West Allis, WI 53227-2455

Phone

(414) 328-8760

Fax

(414) 328-8763

NPI assigned

Jun 1, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449100800000",
    "number": "1811999063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2424 S 90TH ST",
            "address_2": "STE 506",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272455",
            "telephone_number": "414-328-8760",
            "fax_number": "414-328-8763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 S 90TH ST",
            "address_2": "STE 506",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272455",
            "telephone_number": "414-328-8760",
            "fax_number": "414-328-8763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "RICHARD",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2015-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WI",
            "license": "19876",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA-RAILROAD",
            "identifier": "18197019",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30939300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Nicole Danforth, OTR/L
• Daniel & Max, LLC
• Gregory Robert Daniels, D.C.
• Magdalene Helene Danzer-Malinowski, M.S.
• Susan L Darmstadter, M.D.
• Erica Davis, LPN
• Shannon Elyse Davis, OTD, OTR/L
• Michael J Dawson, MD
• Mark Dawydowycz, PA
• Teresa M De la Garza

• Ophthalmology Physician in West Allis, WI
• Providers in West Allis, WI by specialty
• Ophthalmology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.