Active NPI
Laura Davenport, CPNP
- Nurse Practitioner
- Atlanta, GA
National Provider Identifier
1972511905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- RN075009
- Practice address
- 1001 Johnson Ferry Rd
Atlanta, GA 30342 - Phone
- (404) 785-3826
- Fax
- (404) 785-3850
- NPI assigned
- Aug 4, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | RN075009 | GA | Primary |
Addresses
Primary practice location
1001 Johnson Ferry Rd
Atlanta, GA 30342
Mailing address
4635 Mountain Creek Dr
Roswell, GA 30075
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Certified Pediatric Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN075009 | GA | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1972511905",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4635 MOUNTAIN CREEK DR",
"city": "ROSWELL",
"state": "GA",
"postal_code": "30075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 JOHNSON FERRY RD",
"city": "ATLANTA",
"state": "GA",
"postal_code": "30342",
"telephone_number": "404-785-3826",
"fax_number": "404-785-3850"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVENPORT",
"first_name": "LAURA",
"credential": "CPNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "GA",
"license": "RN075009",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.