Organization Active NPI

Davenport Chiropractic, P.a.

  • Chiropractor
  • Jacksonville, FL
National Provider Identifier
1922263052
Registry record updated Oct 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH6642 Issued in FL
Legal business name
DAVENPORT CHIROPRACTIC, P.A.
Practice address
4745 Sutton Park CT Ste 404
Jacksonville, FL 32224-0255
Phone
(904) 246-1512
Fax
(904) 246-8105
NPI assigned
Jul 29, 2008
Last updated
Oct 19, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Austin Glennon, DCNPI 1245585645
Title
Owner
Phone
(904) 246-1512

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH6642 FL Primary

Addresses

Primary practice location

4745 Sutton Park CT Ste 404
Jacksonville, FL 32224-0255

Mailing address

4745 Sutton Park CT Ste 404
Jacksonville, FL 32224-0255
Phone (904) 246-1512

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060214000532 FL Part B Supplier - Clinic/Group Practice 9537174438 Receives reassigned benefits from 2 practitioners
Practice locations: Jacksonville Beach, FL

National Provider Directory

National Provider Directory

Locations

4745 Sutton Park Ct
Ste 404
Jacksonville, FL 32224

730 Beach Blvd
Ste 101
Jax Bch, FL 32250
Phone (904) 246-1512

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1217289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792368000000",
    "number": "1922263052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4745 SUTTON PARK CT STE 404",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322240255",
            "telephone_number": "904-246-1512",
            "fax_number": "904-246-8105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4745 SUTTON PARK CT STE 404",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322240255",
            "telephone_number": "904-246-1512",
            "fax_number": "904-246-8105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVENPORT CHIROPRACTIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-29",
        "last_updated": "2026-10-19",
        "certification_date": "2026-10-19",
        "status": "A",
        "authorized_official_last_name": "GLENNON",
        "authorized_official_first_name": "AUSTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-246-1512",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH6642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.