TIMOTHY CHAD DAVENPORT (NPI# 1760653505) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760653505 |
| Entity Type | Individual |
| Full Name | TIMOTHY CHAD DAVENPORT |
| Credential | M.D. |
| Practice Address |
700 W Forest Ave Ste 300 Jackson TN 38301-3937 |
| Mailing Address |
Po Box 400 Jackson TN 38302-0400 |
| Practice Telephone | 7314220292 |
| Practice Fax Number | 7314220402 |
| Mailing Telephone | 7314238697 |
| Mailing Fax Number | 7314225743 |
| Enumeration Date | 2008-03-20 |
| Last Update Date | 2012-11-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 45054 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | BCBS NUMBER | 4231017 | 01 |
| TN | 1514816 | 05 |
| Street Address |
700 W FOREST AVE STE 300 |
| City | JACKSON |
| State | TN |
| Zip Code | 38301-3937 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801881958 | Heath Broussard | Surgery | 700 W Forest Ave, Ste 300, Jackson, TN 38301-3937 | 2005-09-14 |
| 1659723823 | Jennifer S Mcfarland | Nurse Practitioner | 700 W Forest Ave, Ste 300, Jackson, TN 38301-3937 | 2016-07-12 |
| 1164767133 | Lisa Jewel Alexander Nwokolo | Nurse Practitioner | 700 W Forest Ave, Ste 300, Jackson, TN 38301-3937 | 2012-12-03 |
| 1487970497 | William Charles Barrow | Psychiatry & Neurology | 700 W Forest Ave, Ste 200, Jackson, TN 38301-3937 | 2010-04-15 |
| 1033448642 | Amanda Caroline Holley | Audiologist | 700 W Forest Ave, Ste. 300, Jackson, TN 38301-3937 | 2009-12-10 |
| 1275868390 | West Tennessee Medical Group Inc | Durable Medical Equipment & Medical Supplies | 700 W Forest Ave, Suite 200, Jackson, TN 38301-3937 | 2009-10-07 |
| 1689816142 | Timothy Philip Love | Surgery | 700 W Forest Ave, Ste 300, Jackson, TN 38301-3937 | 2009-03-30 |
| 1407092836 | Margaret J Spragins | Nurse Practitioner | 700 W Forest Ave, Ste 300, Jackson, TN 38301-3937 | 2009-01-07 |
| 1063675692 | Fausta Ditah | Internal Medicine | 700 W Forest Ave, Ste 300, Jackson, TN 38301-3937 | 2008-07-03 |
| 1356528442 | Shahzad Shah | Internal Medicine | 700 W Forest Ave, Ste 300, Jackson, TN 38301-3937 | 2008-01-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124634696 | Lindsey Crowder | Social Worker | 127 Mccowat Street, Jackson, TN 38301 | 2020-09-21 |
| 1366928087 | Primary Care - South Limited | Clinic/Center | 1385 South Highland Ave, Suite B-1, Jackson, TN 38301 | 2018-07-16 |
| 1629592522 | Tlc Home Care Services, LLC | In Home Supportive Care | 39 Old Denmark Rd, Jackson, TN 38301 | 2017-08-01 |
| 1841730421 | Southern Hands Quality Care | In Home Supportive Care | 1298 N. Highland Avenue. Suite 14, Jackson, TN 38301 | 2017-03-02 |
| 1881044477 | Katie Mcmickin | Counselor | 163 Sunnyside Dr, Jackson, TN 38301 | 2016-06-15 |
| 1164815064 | Hailey Archer | Dietitian, Registered | 720 W. Forest Ave., Jackson, TN 38301 | 2015-03-17 |
| 1740673714 | Regina Tignor | Nurse Practitioner | 1410 Us Highway 70 Byp, Jackson, TN 38301 | 2015-03-13 |
| 1194114033 | Woman's Clinic | Obstetrics & Gynecology | 242 Coatsland, Jackson, TN 38301 | 2015-01-15 |
| 1659797702 | Worthy Walker Arrington | Nurse Practitioner | 720 West Forest Avenue, Jackson, TN 38301 | 2014-03-13 |
| 1669717302 | Lift Wellness Inc | General Practice | 101 Jackson Walk Plaza, Jackson, TN 38301 | 2012-12-06 |
| Find all providers in zip 38301 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639305592 | William Meredith Brodford | Urology | 3916 Pinewood, Dr., Jackson, MS 39211-6444 | 2009-06-05 |
| 1689762916 | Jonathan P Sykes | Urology | 1010 Burr Street, Jackson, MI 49201 | 2006-10-11 |
| 1689787566 | Lisa J Finkelstein | Urology | 557 E Broadway, Jackson, WY 83002 | 2006-08-16 |
| 1558370114 | Cascades Urology P.C. | Urology | 2800 Spring Arbor Rd, Jackson, MI 49203-3608 | 2006-08-05 |
| 1851305700 | Metropolitan Urology, Pa | Urology | 971 Lakeland Dr Ste 360, Jackson, MS 39216-4607 | 2006-07-28 |
| 1902837313 | Mississippi Urology Clinic, Pllc | Urology | 501 Marhsall St, Suite 301, Jackson, MS 39202 | 2006-07-05 |
| 1730118696 | Harold Jason Blalock | Urology | 501 Marshall St. Suite 301, Jackson, MS 39202 | 2006-07-02 |
| 1841273190 | Edward Scott Yarbro | Urology | 28 Medical Center Dr, Jackson, TN 38301-3947 | 2005-11-21 |
| 1639160245 | Ted Olin Morgan Jr. | Urology | 555 E Broadway Ave Ste 229, Jackson, WY 83001 | 2005-11-02 |
| 1306831425 | James R Appleton Jr. | Urology | 616 W Forest Ave, Jackson, TN 38301-3902 | 2005-09-14 |
| Find all providers in JACKSON | ||||
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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.