Wendell Davenport

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

Practice address

925 S Semoran Blvd Ste 110a
Winter Park, FL 32792-5313

Phone

(888) 830-1050

NPI assigned

Mar 30, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1942888227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2523 CONTACT ST",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463681939",
            "telephone_number": "219-256-3052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 S SEMORAN BLVD STE 110A",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327925313",
            "telephone_number": "888-830-1050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "WENDELL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-30",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Darrah, M.S.W.
• Darian Darst
• Jennifer C Dasque, ARNP, FNP
• Bella Dattani, M.D.
• Kim Daum, ITDS
• David Carter, Psy.D., PLLC
• David J.D Woska M.D., PA
• David Medical LLC
• David R Parker PHD PLC
• Ashleigh Laura David, FNP-BC

• Physical Therapy Assistant in Winter Park, FL
• Providers in Winter Park, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.