JERRY DAVENPORT (NPI# 1043579725) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043579725 |
| Entity Type | Individual |
| Full Name | JERRY DAVENPORT |
| Credential | LAC |
| Practice Address |
810 Cedar St Girard KS 66743-2056 |
| Mailing Address |
911 E Centennial Dr Pittsburg KS 66762-6601 |
| Practice Telephone | 6207248806 |
| Practice Fax Number | 6207246170 |
| Mailing Telephone | 6202315130 |
| Enumeration Date | 2012-05-15 |
| Last Update Date | 2012-05-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
461 | KS | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114984333 | Jerry Bowman Davenport | Social Worker | 2040 Wilbur Ave, San Diego, CA 92109-1414 | 2006-05-01 |
| 1003935453 | Jerry M. Davenport | Family Medicine | 306 W 5th Ave, Norton Sound Health Cooperation, Nome, AK 99762 | 2007-03-28 |
| Street Address |
810 CEDAR ST |
| City | GIRARD |
| State | KS |
| Zip Code | 66743-2056 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346213923 | Addiction Treatment Center of Southeast Kansas | Community/Behavioral Health | 810 Cedar St, Girard, KS 66743-2056 | 2006-02-13 |
| 1891054557 | Stacey Hauck | Counselor | 810 Cedar St, Girard, KS 66743-2056 | 2012-05-15 |
| 1023377785 | Patrick Lackamp | Counselor | 810 Cedar St, Girard, KS 66743-2056 | 2012-05-15 |
| 1962761932 | Sharon Carpino | Counselor | 810 Cedar St, Girard, KS 66743-2056 | 2012-05-11 |
| 1477754034 | Bob Banks | Counselor | 810 Cedar St, Girard, KS 66743-2056 | 2007-05-30 |
| 1225157639 | Community Mental Health Center of Crawford County | Community/Behavioral Health | 810 Cedar St, Girard, KS 66743-2056 | 2007-03-28 |
| 1396837514 | Judith C Wheeler | Psychologist | 810 Cedar St, Girard, KS 66743-2056 | 2006-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497725477 | Peterson Anesthesia Inc | Nurse Anesthetist, Certified Registered | 302 North Hospital Drive, Girard, KS 66743 | 2006-01-24 |
| 1205821832 | T.w.g. Nursing Home, Inc. | Skilled Nursing Facility | 511 N Western, Girard, KS 66743 | 2005-09-20 |
| 1083831531 | Pittsburg Radiology Associates,pa | Specialist | 302 N Hospital Dr, Girard, KS 66743 | 2007-04-19 |
| 1659345916 | Don Terry Buche | Nurse Anesthetist, Certified Registered | 302 North Hospital Drive, Girard, KS 66743 | 2006-02-14 |
| 1225285000 | Jennifer Kelly | Specialist | 448 E Highway 47, Girard, KS 66743-0172 | 2008-08-22 |
| 1548493992 | Girard Usd248 | Local Education Agency (LEA) | 415 N Summit St, Girard, KS 66743-1128 | 2009-09-02 |
| 1902209703 | Medicalodges, Inc. | Skilled Nursing Facility | 511 N Western Ave, Girard, KS 66743-1152 | 2014-10-07 |
| 1861418444 | Mathis Drug Store, Inc. | Pharmacy | 400 W Saint John St, Girard, KS 66743-1213 | 2006-07-15 |
| 1942229679 | Glen M Mathis | Pharmacist | 400 W Saint John St, Girard, KS 66743-1213 | 2006-07-19 |
| 1285781567 | Steven M.s. Halley | Counselor | 108 E Walnut St, Girard, KS 66743-1337 | 2007-01-05 |
| Find all providers in zip 66743 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184164642 | Kimberly E Veith | Counselor | 244 Main St W, Girard, PA 16417-1616 | 2017-03-03 |
| 1740201862 | Martha Jane Burton-allen | Counselor | 1537 N State St, Girard, OH 44420-1023 | 2006-07-22 |
| 1891054557 | Stacey Hauck | Counselor | 810 Cedar St, Girard, KS 66743-2056 | 2012-05-15 |
| 1023377785 | Patrick Lackamp | Counselor | 810 Cedar St, Girard, KS 66743-2056 | 2012-05-15 |
| 1962761932 | Sharon Carpino | Counselor | 810 Cedar St, Girard, KS 66743-2056 | 2012-05-11 |
| 1477754034 | Bob Banks | Counselor | 810 Cedar St, Girard, KS 66743-2056 | 2007-05-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932700226 | Spencer Shaver | Counselor | 8645 Hauser St, Lenexa, KS 66215-4507 | 2020-11-04 |
| 1871192435 | Shiloah M Feighner | Counselor | 419 Sw 29th, Topeka, KS 66611-1105 | 2020-10-23 |
| 1972101871 | Shara Breeze | Counselor | 815 S Clairborne Rd Ste 225, Olathe, KS 66062-1790 | 2020-10-13 |
| 1235748294 | Compassionate Counseling Services | Counselor | 1807 E Mary St Ste 6, Garden City, KS 67846-3877 | 2020-07-27 |
| 1679194989 | Matthew Rathbun | Counselor | 551 S Holland Ln, Wichita, KS 67209-2007 | 2020-04-28 |
| 1821626987 | Deno Larry Gregory | Counselor | 8600 W 95th St Ste 104-7, Overland Park, KS 66212-3240 | 2020-04-01 |
| 1275168064 | Katherine Fibert | Counselor | 9019 W 10th St N # W10th, Wichita, KS 67212-4020 | 2020-03-12 |
| 1821648353 | Kaye Lynn Scott-roy | Counselor | 285 H Rd, Stockton, KS 67669-8889 | 2019-09-17 |
| 1457907214 | Demay Grunden | Counselor | 200 S Santa Fe Ave Ste 4, Salina, KS 67401-3963 | 2019-08-16 |
| 1154988780 | Michelle Marie Magri | Counselor | 8645 Hauser Court, Lenexa, KS 66215 | 2019-05-20 |
| Find all providers with the same taxonomy | ||||
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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.