Todd Eldon Davenport, DPT OCS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT 27430 Issued in CA

Practice address

1716 W Hammer LN
Stockton, CA 95209-2922

Phone

(209) 473-2383

Fax

(209) 473-1350

NPI assigned

Feb 15, 2006

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• San Luis Physical Therapy & Orthopedic Rehabilitation Inc

  • Physical Therapy Clinic/Center
  • Atascadero, CA
  • NPI 1225046824

  Physical Therapist

  NPD (past)
• San Luis Physical Therapy & Orthopedic Rehabilitation Inc

  • Physical Therapy Clinic/Center
  • Stockton, CA
  • NPI 1578354239

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1952375982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 AEROVISTA PL",
            "address_2": "201",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934017919",
            "telephone_number": "805-788-0805",
            "fax_number": "805-788-0845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1716 W HAMMER LN",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952092922",
            "telephone_number": "209-473-2383",
            "fax_number": "209-473-1350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "TODD",
        "middle_name": "ELDON",
        "name_prefix": "Dr.",
        "credential": "DPT OCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 27430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "7373 West Ln",
            "city": "Stockton",
            "state": "CA",
            "country_code": "US",
            "postal_code": "952103377",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Madiha Daud
• Leanne Lim Dauz
• Crystal Angelina Davenport, ACSW
• Marquita Ann Davenport
• Renee Davenport
• David C. Harris, M.D., Inc.
• David Loth
• David W Davidson
• Pamela Marie Davidson
• Jillian Davies

• Physical Therapist in Stockton, CA
• Providers in Stockton, CA by specialty
• Physical Therapist in California

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