Derek Joseph Davenport
M.D. | Pediatrics | Male
Derek Joseph Davenport, M.D. is a Eagle Mountain, Utah based Pediatric doctor with medical specialization in
General Pediatrics.
Current practice location of Derek Joseph Davenport is
4095 E Pony Express Pkwy Ste 1, Eagle Mountain, Utah - 84005-5531. He can be contacted on phone at
801-429-8037 and fax number 801-753-7476.
Derek Joseph Davenport is a sole proprietor of his business.
NPI number (Unique professional ID) for Derek Joseph Davenport is
1346484581 which was assigned by NPPES on 30 Apr, 2009 and it was last updated on 02 Jun, 2020.
Derek Joseph Davenport license number is
11327523-1205 for Pediatrics (208000000X) in Utah.
Derek Joseph Davenport is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
Derek Joseph Davenport basic information including his official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
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| Provider Name : | Derek Joseph Davenport |
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| Credential : | M.D. |
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| Gender : | Male |
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Business Address:
Derek Joseph Davenport address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 4095 E Pony Express Pkwy Ste 1
Eagle Mountain, UT, 84005-5531
United States |
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| Phone Number : | 801-429-8037 |
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| Fax Number : | 801-753-7476 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1346484581 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 30 Apr, 2009 |
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| Last Updated On : | 02 Jun, 2020 |
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Medicare Participation:
Derek Joseph Davenport participates in medicare and accepts medicare insurance either directly or through association with group practice or medical facility.
| Medicare PECOS ID : | 7911140058 |
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| Medicare Enrollment ID : | I20191205001032 |
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| Primary Specialty : | Pediatric Medicine |
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| Medical School : | Other |
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| Graduation Year : | 2009 |
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| Accepts Medicare? | Yes. Derek Joseph Davenport accepts medicare insurance. |
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Group Practice Association:
Derek Joseph Davenport is associated with following Group Practice Organizations. Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name with which Derek Joseph Davenport is associated with along with the number of members in that group. He may also accept medicare indirectly via these group practices.
| Organisation Name : | Group Practice ID | No. of Members | Practice Address | Group Accepts Medicare |
|---|
| Central Utah Clinic, P.c. | 7517868508 | 382 | 4095 E Pony Express Pkwy
Suite 1
Eagle Mountain, UT - 840055531
Ph: 8014298037 | Yes |
Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Derek Joseph Davenport are as mentioned. Primary taxonomy code for Derek Joseph Davenport, M.D. is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 207R00000X | Internal Medicine | No | MD162235 | OR |
| 207R00000X | Internal Medicine | No | 11327523-1205 | UT |
| 208000000X | Pediatrics | Yes | 11327523-1205 | UT |
| 208000000X | Pediatrics | No | MD162235 | OR |
Legacy Identifiers:
Other legacy medical identifiers of Derek Joseph Davenport such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 500659989 | MEDICAID | OR | |
| 1346484581 | Other | | NPI |
Endpoints:
Endpoints provide a simple, secure, scalable, and standards-based way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the Internet. It is used by EHR systems (Electronic Health Records).
| Endpoint Type | Endpoint | Affiliation | Use | Content | Address |
|---|
DIRECT
(Direct Messaging Address) | medreview@reverehealth.com
| |
|
| 4095 E PONY EXPRESS PKWY STE 1,
EAGLE MOUNTAIN, UT, 84005-5531
United States |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 1055 N 500 W, Attn. Credentialing
Provo, UT, 84604
United States |
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| Phone Number : | 801-354-8225 |
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| Fax Number : | 801-418-0941 |
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Business Location:
Patients can refer following map for directions to
Derek Joseph Davenport practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.