STEPHANIE ANNE DAVENPORT (NPI# 1003862186) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003862186 |
| Entity Type | Individual |
| Full Name | STEPHANIE ANNE DAVENPORT |
| Credential | PAC |
| Practice Address |
50505 Schoenherr Rd Suite 290 Shelby Township MI 48315-3140 |
| Practice Telephone | 5863140054 |
| Practice Fax Number | 5867316275 |
| Mailing Telephone | 5863140054 |
| Mailing Fax Number | 5867316275 |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2011-03-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | NCCPA CERTIFICATE NUMBER | 1054094 | 01 |
| MI | BCBSM | 0E00425 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497374649 | Stephanie Lee Davenport | Student in an Organized Health Care Education/Training Program | 13001 Southern Blvd, Loxahatchee, FL 33470-9203 | 2020-04-08 |
| 1518470285 | Stephanie Lea Davenport | Registered Nurse | 1000 E 24th St, Kansas City, MO 64108-2776 | 2017-11-15 |
| Street Address |
50505 SCHOENHERR RD SUITE 290 |
| City | SHELBY TOWNSHIP |
| State | MI |
| Zip Code | 48315-3140 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427051127 | Grant Adam Lange | Internal Medicine | 50505 Schoenherr Rd, Suite 300, Shelby Township, MI 48315-3140 | 2005-05-27 |
| 1366092769 | Carly Knudsen | Nurse Practitioner | 50505 Schoenherr Rd, Ste 340, Shelby Township, MI 48315-3140 | 2019-09-17 |
| 1497281935 | Nicole Erin Graessle | Nurse Practitioner | 50505 Schoenherr Rd, Shelby Township, MI 48315 | 2017-05-03 |
| 1013455922 | Russell Miller | Nurse Practitioner | 50505 Schoenherr Rd, Ste. 340, Shelby Township, MI 48315-3140 | 2017-02-11 |
| 1699223982 | Elizabeth Anne White | Dermatology | 50505 Schoenherr Rd, Suite 325, Shelby Township, MI 48315-3140 | 2016-09-14 |
| 1558761510 | Rachel Menger | Counselor | 50505 Schoenherr Rd, Shelby Township, MI 48315-3140 | 2014-08-27 |
| 1003222902 | Ciara Braun | Counselor | 50505 Schoenherr Rd, Suite 270, Shelby Township, MI 48315-3140 | 2014-07-11 |
| 1417361361 | Cynthia Shields | Nurse Practitioner | 50505 Schoenherr Rd, Suite 340, Shelby Township, MI 48315-3140 | 2014-06-19 |
| 1003226622 | Gi Medical Assoc PC | Internal Medicine | 50505 Schoenherr Rd, 250, Shelby Township, MI 48315-3140 | 2014-05-05 |
| 1639594799 | Stephanie Bazydlo | Dietitian, Registered | 50505 Schoenherr Rd, Suite 240, Shelby Township, MI 48315-3140 | 2014-02-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649885500 | Steven William Scavone | Counselor | 45660 Schonherr Rd., Shelby Township, MI 48315 | 2020-09-08 |
| 1861039844 | Lauren Nicole Himmel | Physician Assistant | 13051 Michael Dr., Shelby Twp., MI 48315 | 2019-12-09 |
| 1881173763 | Shelby Family Cosmetic & Restorative Dentistry | Dentist | 51221 Schoenherr Road., Suite 102, Shelby Township, MI 48315 | 2018-08-10 |
| 1023594223 | Apex Chiropractic, P.C. | Chiropractor | 51543 Schoenherr Road, Shelby Township, MI 48315 | 2018-07-11 |
| 1053809145 | Bam Management | Clinic/Center | 13433 Hall Road, Utica, MI 48315 | 2018-04-25 |
| 1659723203 | Patricia Gates | Registered Nurse | 23066 Balcombe, Utica, MI 48315 | 2016-07-07 |
| 1124481213 | Jai Shree Umiya Inc | Durable Medical Equipment & Medical Supplies | 13350 24 Mile Rd Ste 300, Shelby Township, MI 48315 | 2016-04-05 |
| 1679931828 | Team Rehabilitation S3, LLC | Physical Therapist | 13350 24 Mile Road, Suite 500, Shelby Township, MI 48315 | 2016-02-03 |
| 1164816484 | Sylvia White | Case Manager/Care Coordinator | 47100 Schoenherr Rd. Suite D, Shelby Township, MI 48315 | 2015-03-25 |
| 1770921389 | Amy Christine Vitale | Speech-Language Pathologist | 14145 Simone Dr., Developing Connections Inc, Shelby Twp, MI 48315 | 2013-06-06 |
| Find all providers in zip 48315 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225692387 | Integrative Family Care, Pllc | Physician Assistant | 52915 Mound Rd, Shelby Township, MI 48316-3266 | 2019-04-24 |
| 1679880256 | Laura Sinistaj | Physician Assistant | 50505 Schoenherr Rd, Ste 340, Shelby Township, MI 48315-3140 | 2010-09-03 |
| 1245396977 | Stacy Nicole Skaltsounis | Physician Assistant | 50505 Schoenherr Rd, Suite 340, Shelby Township, MI 48315-3140 | 2006-12-28 |
| 1154438745 | Theresa Lynne Labranche | Physician Assistant | 8180 26 Mile Rd, Suite 104, Shelby Township, MI 48316-5129 | 2006-08-23 |
| 1831118728 | Susan Curtis | Physician Assistant | 49310 Van Dyke Ave, Shelby Township, MI 48317-1335 | 2006-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023616687 | Alexandria Jaclyn Miller | Physician Assistant | 4700 Chipman Dr, Waterford, MI 48327-3413 | 2020-10-15 |
| 1639777287 | Piotr Z Purzycki | Physician Assistant | 41400 Dequindre Rd Ste 101, Sterling Heights, MI 48314-3751 | 2020-10-15 |
| 1013524859 | Amber Marie Lee | Physician Assistant | 2265 South Lindenroad, Suite A, Flint, MI 48532 | 2020-09-25 |
| 1326656844 | Dominic Farrell | Physician Assistant | 224 Portchester Rd, Holland, MI 49424-2628 | 2020-07-21 |
| 1982212072 | Alexandria Bower-nelson | Physician Assistant | 1302 Porter Drive, Charlotte, MI 48813 | 2020-07-15 |
| 1013535343 | Maria Pavia | Physician Assistant | 41302 Scarborough Ln, Novi, MI 48375-2893 | 2020-07-13 |
| 1073130241 | Kelly F Esper | Physician Assistant | 9043 Glenwood Ln, Northville, MI 48168-9129 | 2020-07-02 |
| 1811513971 | Tasha Baker | Physician Assistant | 5444 E Whitefeather Rd, Pinconning, MI 48650-8407 | 2020-06-24 |
| 1437770054 | Sterling Ryan Maxfield | Physician Assistant | 6187 Oak Grove Rd, Howell, MI 48855-8247 | 2020-05-05 |
| 1760018808 | Rachel Renee Mackmin | Physician Assistant | 41498 Mary Kay Dr, Clinton Township, MI 48038-1989 | 2020-03-20 |
| Find all providers with the same taxonomy | ||||
| City | SHELBY TOWNSHIP |
| Zip Code | 48315 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.