Charles W. Davenport Jr., M.D.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

13521 Issued in MS

Practice address

1800 12TH St
Meridian, MS 39301-4158

Phone

(601) 703-4065

Fax

(601) 703-3050

NPI assigned

Nov 17, 2005

Last updated

Nov 6, 2013By 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

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Cardiovascular Disease (Cardiology)

Education

University of Mississippi School of Medicine, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medical Foundation IncGroup PAC ID 9234043712, 211 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ochsner Rush Hospital Hospital, Meridian, MS, CCN 250069
• Ochsner Scott Regional Hospital, Morton, MS, CCN 251323
• Ochsner Laird Hospital Hospital, Union, MS, CCN 251322
• Anderson Regional Medical Center Hospital, Meridian, MS, CCN 250104
• Ochsner Stennis Memorial Hospital Hospital, De Kalb, MS, CCN 251335

Merit-based Incentive Payment System (MIPS)

Final score

72.16 of 100Reported as individual

Quality

85

Improvement activities

0

Cost

76.83

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Medical Foundation, Inc.

  • Family Medicine Physician
  • Meridian, MS
  • NPI 1609820539
  Medicare reassignment Care Compare group
• Rush Medical Foundation

  dba Ochsner Rush Medical Center

  • General Acute Care Hospital
  • Meridian, MS
  • NPI 1770543399
  NPD (past)

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

• Anderson Regional Medical Center

  dba Baptist Anderson Regional Medical Center

  • General Acute Care Hospital
  • Meridian, MS
  • NPI 1649226952
  Care Compare affiliation
• Kemper Cah, Inc.

  dba Ochsner Stennis Hospital

  • Critical Access Hospital
  • De Kalb, MS
  • NPI 1679875645
  Care Compare affiliation
• Laird Hospital, Inc.

  dba Ochsner Laird Hospital

  • Critical Access Hospital
  • Union, MS
  • NPI 1518924752
  Care Compare affiliation
• Rush Medical Foundation

  dba Ochsner Rush Medical Center

  • General Acute Care Hospital
  • Meridian, MS
  • NPI 1770543399
  Care Compare affiliation
• Scott Regional Medical Center, Inc.

  dba Ochsner Scott Regional

  • Critical Access Hospital
  • Morton, MS
  • NPI 1134278435
  Care Compare affiliation

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

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383696000000",
    "number": "1851373674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 12TH ST",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014158",
            "telephone_number": "601-703-9506",
            "fax_number": "601-703-3264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 12TH ST",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014158",
            "telephone_number": "601-703-4065",
            "fax_number": "601-703-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "CHARLES",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-17",
        "last_updated": "2013-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MS",
            "license": "13521",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009809870",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00115846",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "060048292",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF AL",
            "identifier": "731-02314",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• D & D Health Supply LLC
• Linda Mary Dales, MD
• George Daniel, MD
• Tiffany D Danowski, RN
• Kent A Darsey, M.D.
• David a. Pomierski, MD, PA
• David Ashley MD DMD Oral Surgery Group, a Professional Dental Corporation (Oral Surgery and Wisdom Teeth of Mississippi)
• David M Gilmore DMD PA
• Bridget A. Davidson, CRNA
• Sheila Darlene Davidson, NURSE PRACTITIONER

• Cardiovascular Disease Physician in Meridian, MS
• Providers in Meridian, MS by specialty
• Cardiovascular Disease Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2013; 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.