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DARRYL LAMONT DAVENPORT PA-C
NPI 1396900965
Physician Assistant - Medical in Camp Pendlton, CA

Active since July 23, 2008PECOS Enrolled
200 MERCY CR, CAMP PENDLTON, CA 92055(951) 308-2200 Get Directions Write a Review

NPPES record last updated: March 11, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 11, 2025, Mar 17, 2018, Dec 14, 2017 (3 updates tracked since 2017).

About Darryl Lamont Davenport Pa-c NPPES

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

DARRYL LAMONT DAVENPORT PA-C (NPI 1396900965) is an individual medical provider in Camp Pendlton, California, licensed in California (54451) and active in the NPI registry since July 2008. He is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1396900965
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameDARRYL LAMONT DAVENPORTCredential: PA-C
Location Address200 MERCY CRCamp Pendlton, CA 92055
Mailing Address3406a Daly StTwentynine Palms, CA 92277-9467 · (760) 830-6065
Phone(951) 308-2200
Sole ProprietorNo
Enumeration DateJuly 23, 2008
Last NPPES UpdateMarch 11, 20253 updates tracked since enumeration
NPPES CertifiedMarch 4, 2025
✔ NPI 1396900965 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in CA · 54451
Also ListedPhysician AssistantTaxonomy 363A00000X · License 54451 (CA)
200 MERCY CR, Camp Pendlton, CA 92055
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Secondary Practice Locations 2

Location 1100 Brewster Blvd, ATTN II MEF MHG GASCamp Lejeune, NC 28547-2538 · Phone (910) 451-2635
Location 227168 Newport Rd Ste 1Menifee, CA 92584-7383 · Phone (951) 246-3033 · Fax (951) 246-7373

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Darryl Lamont Davenport Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Other Providers at the Same Location NPPES

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

ERIC STEVENS
Dentist
200 MERCY CR
OCEANSIDE, CA 92055
San Diego County (940) 782-1766

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 Darryl Davenport's NPI number?

The NPI number for Darryl Davenport is 1396900965. It was assigned to this individual provider in the NPPES registry on July 23, 2008.

Where is Darryl Davenport located?

Darryl Davenport practices at 200 Mercy Cr, Camp Pendlton, CA 92055. The listed phone number is (951) 308-2200.

What is Darryl Davenport's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Darryl Davenport enrolled in Medicare?

Yes. Darryl Davenport is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Darryl Davenport was last updated on March 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.