Betty Jean Davenport, HOME HEALTH AID

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

2777786 Issued in OH

Practice address

3209 List St NW
Massillon, OH 44646-2837

Phone

(330) 837-7796

NPI assigned

Mar 27, 2008

Last updated

Mar 27, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

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

{
    "created_epoch": "1206576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206576000000",
    "number": "1881866143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3209 LIST ST NW",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446462837",
            "telephone_number": "330-837-7796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3209 LIST ST NW",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446462837",
            "telephone_number": "330-837-7796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "BETTY",
        "middle_name": "JEAN",
        "credential": "HOME HEALTH AID",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-27",
        "last_updated": "2008-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "OH",
            "license": "2777786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "2777786",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Daniel
• Tiffany Daniell Daniels
• Louise Dapoz, MSN, CNP
• Darkheart Apocathery (Darkheart Dispensary)
• Jeffrey Scott Darnell, LPN
• Jayanna Monique Davenport
• Kerrie Lynn David, D.O.
• Shawnta Monique Davidson, LPN
• Robert E. Davies, RPH
• Christopher James Davis, D.O.

• Community Health Worker in Massillon, OH
• Providers in Massillon, OH by specialty
• Community Health Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.