SAMUEL V DAVENPORT CRNA
NPI 1083616056
Nurse Anesthetist, Certified Registered in Johnson City, TN

Q: What is Samuel Davenport's NPI number?

The NPI number for Samuel Davenport is 1083616056. It was assigned to this individual provider in the NPPES registry on August 10, 2005.

Q: What is Samuel Davenport's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Q: When was this NPI record last updated?

The NPPES record for Samuel Davenport was last updated on April 24, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 10, 2005

400 N STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604(423) 431-6111 Get Directions Write a Review

NPPES record last updated: April 24, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Samuel V Davenport Crna NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMUEL V DAVENPORT CRNA (NPI 1083616056) is an individual nurse anesthetist, certified registered in Johnson City, Tennessee, licensed in Tennessee (RN0000104846) and active in the NPI registry since August 2005. He maintains a secondary practice location in Johnson City.

NPPES Registry Identity

NPI1083616056

Entity TypeIndividualMale

Primary Taxonomy367500000X

Provider Legal NameSAMUEL V DAVENPORTCredential: CRNA

Location Address400 N STATE OF FRANKLIN RDJohnson City, TN 37604-6035

Mailing Address1009 Lark St Ste 2Johnson City, TN 37604-8218 · (423) 283-0776 · Fax (423) 283-0549

Phone(423) 431-6111

Sole ProprietorNo

Enumeration DateAugust 10, 2005

Last NPPES UpdateApril 24, 2019

✔ NPI 1083616056 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367500000X

License✔ Licensed in TN · RN0000104846

Definition

(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.

400 N STATE OF FRANKLIN RD, Johnson City, TN 37604

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Secondary Practice Location 1

Location 1300 Med Tech PkwyJohnson City, TN 37604-2277 · Phone (423) 302-1000

Other Identifiers 1

Medicaid3631202TN

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. CASEY JAMES WILBERT PHARM.D

Pharmacist

400 N STATE OF FRANKLIN RD
JOHNSON CITY, TN 37604

Washington County (423) 431-2787

BLUE RIDGE MEDICAL MANAGEMENT CORPORATION

Internal Medicine (Cardiovascular Disease)

400 N STATE OF FRANKLIN RD, ROOM LK015
JOHNSON CITY, TN 37604

Washington County (423) 431-5965

MITCHELL DESHAZER

Internal Medicine (Critical Care Medicine)

400 N STATE OF FRANKLIN RD, ROOM 2746
JOHNSON CITY, TN 37604

Washington County (423) 431-2727

DR. ANDREW LEE GIBSON MD

Emergency Medicine

400 N STATE OF FRANKLIN RD
JOHNSON CITY, TN 37604

Washington County (423) 431-6111

MCKENZIE PEARL GREGG PA-C, MMS, MPH

Physician Assistant

400 N STATE OF FRANKLIN RD
JOHNSON CITY, TN 37604

Washington County (423) 431-6111

OLUWATOSIN ORIOLA AYANJOKE MD

Family Medicine

400 N STATE OF FRANKLIN RD
JOHNSON CITY, TN 37604

Washington County (423) 431-6111

HUNTER DORTON

Student in an Organized Health Care Education/Training Program

400 N STATE OF FRANKLIN RD
JOHNSON CITY, TN 37604

Washington County (423) 431-6111

DR. LEON CHARLES BASS M.D.

Internal Medicine (Pulmonary Disease)

400 N STATE OF FRANKLIN RD, ROOM 2746
JOHNSON CITY, TN 37604

Washington County (423) 431-2727

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Samuel Davenport's NPI number?

The NPI number for Samuel Davenport is 1083616056. It was assigned to this individual provider in the NPPES registry on August 10, 2005.

Where is Samuel Davenport located?

Samuel Davenport practices at 400 N State Of Franklin Rd, Johnson City, TN 37604. The listed phone number is (423) 431-6111.

What is Samuel Davenport's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

When was this NPI record last updated?

The NPPES record for Samuel Davenport was last updated on April 24, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.