Victoria Grace Davenport, CAA

Key facts

NPI

1821985409

Entity type

Individual (NPI type 1)

Primary specialty

Anesthesiologist Assistant 367H00000X

License

2025024785 (MO)

Practice address

2525 Glenn Hendren Dr
Liberty, MO 64068-9625

Phone

(816) 781-7200

NPI assigned

Jun 18, 2025

Sex

Unspecified or another gender identity

Sole proprietor

No

Organizations & group practices 2

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.

• Professional Anesthetic Care Inc Anesthesiology Physician · Liberty, MO · NPI 1922053461
  Medicare reassignment Care Compare group NPD MO
• James F Piontek Inc Pain Medicine (Anesthesiology) Physician · Liberty, MO · NPI 1508034828
  NPD (past)

Hospital & facility affiliations 1

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

• New Liberty Hospital Corporation General Acute Care Hospital · Liberty, MO · NPI 1548001464
  Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty

Anesthesiology Assistant

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Professional Anesthetic Care Inc (30 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• Liberty Hospital Hospital · Liberty, MO · CCN 260177

Medicare participation

Medicare fee-for-service enrollment

Enrolled in MO

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Associate of Arts

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 31, 2025.

{
    "created_epoch": "1750204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761868800000",
    "number": "1821985409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 SE GRAHAM RIDGE RD",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640144101",
            "telephone_number": "816-308-6486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 GLENN HENDREN DR",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640689625",
            "telephone_number": "816-781-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "VICTORIA",
        "middle_name": "GRACE",
        "credential": "CAA",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-06-18",
        "last_updated": "2025-10-31",
        "certification_date": "2025-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "MO",
            "license": "2025024785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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