HYRUM DAVENPORT NP
NPI 1255567210
Nurse Practitioner in Chubbuck, ID

Q: What is Hyrum Davenport's NPI number?

The NPI number for Hyrum Davenport is 1255567210. It was assigned to this individual provider in the NPPES registry on June 4, 2009.

Q: What is Hyrum Davenport's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Hyrum Davenport was last updated on September 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months 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 June 04, 2009PECOS EnrolledAccepts Medicare Assignment

4650 HAWTHORNE RD STE 3B, CHUBBUCK, ID 83202(208) 252-5621(208) 648-4167 Get Directions Write a Review

NPPES record last updated: September 23, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Hyrum Davenport Np NPPES

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

HYRUM DAVENPORT NP (NPI 1255567210) is an individual nurse practitioner in Chubbuck, Idaho, licensed in Idaho (NP-913A) and active in the NPI registry since June 2009. He is enrolled in Medicare PECOS and is a graduate of Other (2007).

NPPES Registry Identity

NPI1255567210

Entity TypeIndividualMale

Primary Taxonomy363L00000X

Provider Legal NameHYRUM DAVENPORTCredential: NP

Location Address4650 HAWTHORNE RD STE 3BChubbuck, ID 83202-2376

Mailing AddressPo Box 2516Pocatello, ID 83206-2516 · (208) 252-5621 · Fax (208) 648-4167

Phone(208) 252-5621

Fax(208) 648-4167

Sole ProprietorNo

Medical School CMSOtherGraduated 2007

Enumeration DateJune 4, 2009

Last NPPES UpdateSeptember 23, 2025

NPPES CertifiedSeptember 23, 2025

✔ NPI 1255567210 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in ID · NP-913A

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

4650 HAWTHORNE RD STE 3B, Chubbuck, ID 83202

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, PacificSource Health Plans, Providence Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Hyrum Davenport Np is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4789736083

PECOS Enrollment IDI20090717000227, I20230206000957

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

115 services33 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83202 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$81.13 typical visit price

range $52.44 – $160.17

Typical copayment $20.28 (range $13.11 – $40.04)

Most-billed visit code 99203

Established Patient

$93.26 typical visit price

range $16.68 – $130.93

Typical copayment $23.31 (range $4.17 – $32.73)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 18

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

BRANDY LYNN GILEA MS-SLP

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