Kenneth K Davenport, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

29230 Issued in AL

Practice address

1026 Goodyear Ave Ste 302B
Gadsden, AL 35903-1194

Phone

(256) 485-0899

Fax

(866) 265-9563

NPI assigned

Nov 19, 2007

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 AL

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

General Surgery

Education

Other, 2011

Medicare assignment

May accept Medicare assignment

Group practices

Lifehealth PCGroup PAC ID 7315233954, 17 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Gadsden Regional Medical Center Hospital, Gadsden, AL, CCN 010040

Merit-based Incentive Payment System (MIPS)

Final score

92.57 of 100Reported as group

Quality

78.21

Improvement activities

40

Cost

78.63

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kenneth.davenport@saog.directbygreenway.com
• FHIR API: https://fhir4.healow.com/fhir/r4/CCDGAD

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.

• Lifehealth, P.C.

  • Nephrology Physician
  • Gadsden, AL
  • NPI 1093168437

  Surgery

  Medicare reassignment Care Compare group NPD

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

• Gadsden Regional Medical Center LLC

  • General Acute Care Hospital
  • Gadsden, AL
  • NPI 1225081516
  Care Compare affiliation

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

{
    "created_epoch": "1195430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735603200000",
    "number": "1891976833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1026 GOODYEAR AVE STE 302B",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359031194",
            "telephone_number": "256-485-0899",
            "fax_number": "866-265-9563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 GOODYEAR AVE STE 302B",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359031194",
            "telephone_number": "256-485-0899",
            "fax_number": "866-265-9563"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 Goodyear Avenue",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "Gadsden",
            "state": "AL",
            "postal_code": "359031108",
            "country_code": "US",
            "telephone_number": "256-492-0020",
            "fax_number": "256-492-0029",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2525 US Highway 431 Ste 270",
            "address_purpose": "LOCATION",
            "city": "Boaz",
            "state": "AL",
            "postal_code": "359575934",
            "country_code": "US",
            "telephone_number": "256-485-0899",
            "fax_number": "866-265-9563",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7938 Al Highway 69 Ste 360",
            "address_purpose": "LOCATION",
            "city": "Guntersville",
            "state": "AL",
            "postal_code": "359767177",
            "country_code": "US",
            "telephone_number": "256-485-0899",
            "fax_number": "866-265-9563",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2055 E South Blvd Ste 708",
            "address_purpose": "LOCATION",
            "city": "Montgomery",
            "state": "AL",
            "postal_code": "361162014",
            "country_code": "US",
            "telephone_number": "334-457-7212",
            "fax_number": "866-265-9563",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "70 Plaza Dr",
            "address_purpose": "LOCATION",
            "city": "Pell City",
            "state": "AL",
            "postal_code": "351259314",
            "country_code": "US",
            "telephone_number": "256-485-0899",
            "fax_number": "866-265-9563",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2001 Cades Ave SW",
            "address_purpose": "LOCATION",
            "city": "Fort Payne",
            "state": "AL",
            "postal_code": "359683554",
            "country_code": "US",
            "telephone_number": "256-485-0899",
            "fax_number": "866-265-9563",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "KENNETH",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-19",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AL",
            "license": "29230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529203130",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130499",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD ALABAMA",
            "identifier": "511-17039",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "D570",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Gadsden, AL
• Providers in Gadsden, AL by specialty
• Surgery Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2024; 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.