William J Davenport, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5601005653 Issued in MI

Practice address

1500 E Sherman Blvd
Muskegon, MI 49444-1849

Phone

(231) 672-3883

Fax

(231) 672-3973

NPI assigned

Jul 7, 2006

Last updated

Aug 20, 2012By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

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

Physician Assistant

Education

Jefferson Medical College of Thomas Jefferson University, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeastern Intensivist Services PCGroup PAC ID 9335152107, 234 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• CJW Medical Center Hospital, Richmond, VA, CCN 490112

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Southeastern Intensivist Services PC

  • Hospitalist Physician
  • West Memphis, AR
  • NPI 1912942665

  VA

  Medicare reassignment Care Compare group
• Newaygo County General Hospital Association

  dba Corewell Health Gerber Hospital

  • Critical Access Hospital
  • Fremont, MI
  • NPI 1063836963
  NPD (past)

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

• Chippenham & Johnston-Willis Hospitals Inc

  dba CJW Medical Center

  • General Acute Care Hospital
  • Richmond, VA
  • NPI 1598708513
  Care Compare affiliation

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345420800000",
    "number": "1851323778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1847",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494431847",
            "telephone_number": "231-727-4444",
            "fax_number": "231-727-4451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E SHERMAN BLVD",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441849",
            "telephone_number": "231-672-3883",
            "fax_number": "231-672-3973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "WILLIAM",
        "middle_name": "J",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2012-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110001951",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601005653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "0N27530065",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adam Joseph Darnell, M.D.
• Virendra K Das, MD
• Dasco HME, LLC (DASCO Home Medical Equipment)
• Erin Dault, LMSW
• Jaymi Renee Dausman
• David B Jackson DDS Ms PLC
• Amber Renee Davidson
• Briana Davis, LMSW
• Brooke C Davis, L.M.S.W.
• Constance Davis

• Medical Physician Assistant in Muskegon, MI
• Providers in Muskegon, MI by specialty
• Medical Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2012; 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.