Shawn D Davenport, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

70-011513 Issued in IL

Practice address

901 Grant St
Harvard, IL 60033-1821

Phone

(815) 943-5431

NPI assigned

Oct 19, 2006

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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 and National Provider Directory roles.

• Harvard Physical Therapy

  • Physical Therapist
  • Harvard, IL
  • NPI 1376688176
  NPD (past)
• Rehab Management Specialists, PC

  • Physical Therapy Clinic/Center
  • Harvard, IL
  • NPI 1720104110

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841372174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 GRANT ST",
            "city": "HARVARD",
            "state": "IL",
            "postal_code": "600331821",
            "telephone_number": "815-943-5431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 GRANT ST",
            "city": "HARVARD",
            "state": "IL",
            "postal_code": "600331821",
            "telephone_number": "815-943-5431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "SHAWN",
        "middle_name": "D",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "70-011513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36104700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allen R.M. Castillo, MD
• Anna Choquette
• Timothy A Chrapkiewicz, DDS
• Community Health Partnership of Illinois
• Community Health Partnership of Illinois
• Evelyn L Dawis, MD
• Sammy T Dean, MD
• Tina Dilts
• Norma G Figueroa, LCSW
• Melissa K Flies, SLP

• Physical Therapist in Harvard, IL
• Providers in Harvard, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.