Hyrum Davenport (NPI# 1255567210, PAC ID# 4789736083) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1255567210 |
| PAC ID by PECOS | 4789736083 |
| Professional Enrollment ID | I20090717000227 |
| Full Name | Hyrum Davenport |
| Organization Legal Name | MVH BMC LLC |
| Address |
1441 Pkwy Dr Blackfoot ID 83221-1667 |
| Phone Number | 2087852600 |
| Gender | M |
| Graduation Year | 2007 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 2961791991 |
| Number of Group Practice Members | 15 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 130065 | MOUNTAIN VIEW HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1441 Pkwy Dr, Blackfoot, ID 83221-1667 | 2087852600 | MVH BMC LLC |
| 855 N Capital Ave, Suite 2, Idaho Falls, ID 83402-3405 | 2082332025 | NEW HORIZONS MENTAL WELLNESS CLINICS |
| 1352 E Ctr St, Suite A, Pocatello, ID 83201-4773 | 2082332025 | NEW HORIZONS MENTAL WELLNESS CLINICS |
| 611 Wilson Ave, Suite 5, Pocatello, ID 83201-5046 | 2082446437 | NEW HORIZONS MENTAL WELLNESS CLINICS |
| 210 S Emerson Ave, Shelley, ID 83274-1229 | 2083577404 | MVH BMC LLC |
| 1223 S Railroad Ave, Sugar City, ID 83448-5072 | 2083594293 | UPPER VALLEY RESOURCE AND COUNSELING LLC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_EP_1 | e-Prescribing | 73% | |
| ACI_EC_TRANS_PEA_1 | Provide Patient Access | 2% | |
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % |
| Organization Legal Name | MVH BMC LLC |
| Physicians | 15 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Max Barney | Nurse Practitioner | Mvh Bmc LLC | 210 S Emerson Ave, Shelley, ID 83274-1229 |
| Heather F Grimmett | Physician Assistant | Mvh Bmc LLC | 1441 Pkwy Dr, Blackfoot, ID 83221-1667 |
| Joy H Taylor | Nurse Practitioner | Mvh Bmc LLC | 1441 Pkwy Dr, Blackfoot, ID 83221-1667 |
| Matthew J Fackrell | Family Medicine | Mvh Bmc LLC | 1441 Pkwy Dr, Blackfoot, ID 83221-1667 |
| Gary Soucie | Family Medicine | Mvh Bmc LLC | 1441 Pkwy Dr, Blackfoot, ID 83221-1667 |
| Dellisa Dawn Eddington | Nurse Practitioner | Mvh Bmc LLC | 1441 Pkwy Dr, Blackfoot, ID 83221-1667 |
| Francis T Johansen | General Surgery | Mvh Bmc LLC | 1441 Pkwy Dr, Blackfoot, ID 83221-1667 |
| Charlynn S Perkes | Physician Assistant | Mvh Bmc LLC | 1441 Pkwy Dr, Blackfoot, ID 83221-1667 |
| Gordon E Dixon Jr. | Family Medicine | Mvh Bmc LLC | 1441 Pkwy Dr, Blackfoot, ID 83221-1667 |
| Steven Clinger | Family Medicine | Mvh Bmc LLC | 1441 Pkwy Dr, Blackfoot, ID 83221-1667 |
| Street Address |
1441 PKWY DR |
| City | BLACKFOOT |
| State | ID |
| Zip | 83221-1667 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kaitlin Bl Vail | Physical Therapy | Rocky Mountain Physical Therapy Pllc | 1441 Pkwy Dr, Suite 1, Blackfoot, ID 83221-1667 |
| James W Taylor | Diagnostic Radiology | Teton Radiology Diagnostic, LLC | 1441 Pkwy Dr, Suite 9, Blackfoot, ID 83221-1667 |
| Heather F Grimmett | Physician Assistant | Mvh Bmc LLC | 1441 Pkwy Dr, Blackfoot, ID 83221-1667 |
| Craig W Allred | Qualified Audiologist | Audiology Services Company Usa LLC | 1441 Pkwy Dr, Blackfoot, ID 83221-1667 |
| Joy H Taylor | Nurse Practitioner | Mvh Bmc LLC | 1441 Pkwy Dr, Blackfoot, ID 83221-1667 |
| Matthew J Fackrell | Family Medicine | Mvh Bmc LLC | 1441 Pkwy Dr, Blackfoot, ID 83221-1667 |
| Gary Soucie | Family Medicine | Mvh Bmc LLC | 1441 Pkwy Dr, Blackfoot, ID 83221-1667 |
| Michael Sean Enslow | Diagnostic Radiology | Teton Radiology Diagnostic, LLC | 1441 Pkwy Dr, Suite 9, Blackfoot, ID 83221-1667 |
| James P Edlin | Diagnostic Radiology | Teton Radiology Diagnostic, LLC | 1441 Pkwy Dr, Suite 9, Blackfoot, ID 83221-1667 |
| Brandon S Hawker | Physical Therapy | Rocky Mountain Physical Therapy Pllc | 1441 Pkwy Dr, Suite 1, Blackfoot, ID 83221-1667 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ryan T Sayre | Certified Registered Nurse Anesthetist (crna) | East Idaho Anesthesia Associates PC | 350 N Meridian St, Blackfoot, ID 83221-1625 |
| Mark L Edlefsen | Certified Registered Nurse Anesthetist (crna) | East Idaho Anesthesia Associates PC | 350 N Meridian St, Blackfoot, ID 83221-1625 |
| Brandon K Pieper | Certified Registered Nurse Anesthetist (crna) | East Idaho Anesthesia Associates PC | 350 N Meridian St, Blackfoot, ID 83221-1625 |
| Zachary D Morrow | Certified Registered Nurse Anesthetist (crna) | East Idaho Anesthesia Associates PC | 350 N Meridian St, Blackfoot, ID 83221-1625 |
| Cory J Sayre | Certified Registered Nurse Anesthetist (crna) | East Idaho Anesthesia Associates PC | 350 N Meridian St, Blackfoot, ID 83221-1625 |
| Shawn M Murray | Certified Registered Nurse Anesthetist (crna) | East Idaho Anesthesia Associates PC | 350 N Meridian St, Blackfoot, ID 83221-1625 |
| Christopher L Wehrli | Certified Registered Nurse Anesthetist (crna) | East Idaho Anesthesia Associates PC | 350 N Meridian St, Blackfoot, ID 83221-1625 |
| Shawn A Wren | Certified Registered Nurse Anesthetist (crna) | East Idaho Anesthesia Associates PC | 350 N Meridian St, Blackfoot, ID 83221-1625 |
| Dee S Stevens | Chiropractic | 725 Jensen Grove Dr, Suite 4, Blackfoot, ID 83221-1636 | |
| Anne M Preston | Clinical Social Worker | Portneuf Valley Family Center, Inc. | 1495 Pkwy Dr C, Blackfoot, ID 83221-1639 |
| Find all physicians in zip 83221 | |||
| City | BLACKFOOT |
| Zip Code | 83221 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | BLACKFOOT + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Hyrum Davenport.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.