Brooke Ashley Davenport

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

1183778 Issued in TX

Practice address

500 W 3Rd Ave Ste 6
Corsicana, TX 75110-4564

Phone

(903) 872-5925

NPI assigned

Jan 18, 2019

Last updated

Jan 18, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Geisinger Clinic

  • Surgery Physician
  • Danville, PA
  • NPI 1255382784
  NPD (past)
• Geisinger-HM Joint Venture, LLC

  • Family Medicine Physician
  • Williamsport, PA
  • NPI 1073075909
  NPD (past)

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

{
    "created_epoch": "1547769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547769600000",
    "number": "1962976332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "533 EDGEWOOD AVE",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751101121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W 3RD AVE STE 6",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751104564",
            "telephone_number": "903-872-5925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "BROOKE",
        "middle_name": "ASHLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-18",
        "last_updated": "2019-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "1183778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fernando Michael Cruz, DPM
• Curb and Key LLC (Freedom Way Mobility)
• CVS Pharmacy Inc (CVS Pharmacy#06854)
• Chari Lynnett Daniels, LVN
• Darrell Van Horn D.M.D M.S
• Ruth Elaine David, MA LPC
• Beverly Sue Davis, MA, LPC-S
• Sonya Davis
• Steven Davis, FITTING AND DISPENSI
• DCS Medical PA

• Physical Medicine & Rehabilitation Physician in Corsicana, TX
• Providers in Corsicana, TX by specialty
• Physical Medicine & Rehabilitation Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2019; 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.