Robert Burton Davenport-Ray, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN112246 Issued in GA

Practice address

124 Andrews Way
Ste B
Saint Marys, GA 31558-1653

Phone

(912) 729-7007

Fax

(912) 729-2031

NPI assigned

Jul 7, 2006

Last updated

Dec 2, 2020By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peds and Parents Family Care, LLCGroup PAC ID 0749697878, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14356/brand/1/csg/1/fhir/r4
• Direct secure messaging: robert.davenport-ray.1@14356.direct.athenahealth.com

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.

• Peds and Parents Family Care, LLC

  • Family Medicine Physician
  • Kingsland, GA
  • NPI 1912115452
  Medicare reassignment Care Compare group NPD
• Privia Medical Group, LLC

  • Internal Medicine Physician
  • Arlington, VA
  • NPI 1013042480
  NPD (past)

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1841223799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 ALOE CT",
            "city": "KINGSLAND",
            "state": "GA",
            "postal_code": "315486215",
            "telephone_number": "912-882-8178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 ANDREWS WAY",
            "address_2": "STE B",
            "city": "SAINT MARYS",
            "state": "GA",
            "postal_code": "315581653",
            "telephone_number": "912-729-7007",
            "fax_number": "912-729-2031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVENPORT-RAY",
        "first_name": "ROBERT",
        "middle_name": "BURTON",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN112246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cumberland Health Services, Inc
• Cumberland Medical Equipment Inc
• Katie Cunningham
• Harsh Trikambhai Dangaria, M.D.
• Breanna Darnell, BSN, RN
• Patrick Davidson, PA-C
• Chatham Davis Jr., SOCIAL WORKER
• Kaelynn Davis
• Grant Christopher Degravelle, DPT, PT
• Nicole D Demick

• Family Nurse Practitioner in Saint Marys, GA
• Providers in Saint Marys, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.