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JACK ADAM DAVENPORT CRNA
NPI 1699102301
Nurse Anesthetist, Certified Registered in Des Moines, IA

Active since September 27, 2013PECOS EnrolledAccepts Medicare Assignment
1200 PLEASANT ST, DES MOINES, IA 50309(515) 241-6372 Get Directions Write a Review

NPPES record last updated: June 26, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jun 26, 2024, Jun 6, 2023 (2 updates tracked since 2023).

About Jack Adam Davenport Crna NPPES

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

JACK ADAM DAVENPORT CRNA (NPI 1699102301) is an individual nurse anesthetist, certified registered in Des Moines, Iowa, licensed in Iowa (121287) and active in the NPI registry since September 2013. He is enrolled in Medicare PECOS, is affiliated with Unitypoint Health - Des Moines Iowa Methodist Medi, and is a graduate of Other (2013).

NPPES Registry Identity

NPI1699102301
Entity TypeIndividualMale
Primary Taxonomy367500000X
Provider Legal NameJACK ADAM DAVENPORTCredential: CRNA
Location Address1200 PLEASANT STDes Moines, IA 50309-1406
Mailing Address4201 Westown Pkwy Ste 236West Des Moines, IA 50266-6720 · (515) 401-1950
Phone(515) 241-6372
Sole ProprietorYes
Medical School CMSOtherGraduated 2013
Enumeration DateSeptember 27, 2013
Last NPPES UpdateJune 26, 20242 updates tracked since enumeration
NPPES CertifiedJune 26, 2024
✔ NPI 1699102301 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 IA · 121287
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.
1200 PLEASANT ST, Des Moines, IA 50309
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jack Adam Davenport Crna 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 ID9638308257
PECOS Enrollment IDI20140131000150
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.

Medicare Billing Reassignment

Medicare enrollment records show Jack Davenport reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Associated Anesthesiologists, P.C.
Same address
Anesthesiology
1200 PLEASANT ST
Des Moines, IA 50309
  • Reassigned Medicare billing, Iowa enrollment
  • Medicare enrollment name: Associated Anesthesiologists PC
  • 66 clinicians in this Medicare group
NPI 1215904750 (515) 401-1950

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

Anesthesia for other procedure on lower abdomen 00840
Anesthesia for a lower abdomen procedure involves medication to eliminate pain during surgery. You might be awake but relaxed and pain-free, or you may be completely unconscious. It's administered to ensure comfort and safety throughout the operation.
22 services22 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Unitypoint Health - Des Moines Iowa Methodist Medi

Acute Care Hospitals · Des Moines, IA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number160082
Location1200 Pleasant StreetDes Moines, IA 50309 · Polk County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 50309 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
$122.23 typical visit price
range $52.96 – $161.40
Typical copayment $30.55 (range $13.24 – $40.35)
Most-billed visit code 99204
Established Patient
$66.36 typical visit price
range $16.91 – $131.98
Typical copayment $16.59 (range $4.22 – $32.99)
Most-billed visit code 99213
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 20

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

CENTRAL IOWA HOSPITAL CORPORATION
Pharmacy
1200 PLEASANT ST
DES MOINES, IA 50309
Polk County (515) 241-5936
CATHERINE P MCNEILL M.D.
Pediatrics
1200 PLEASANT ST
DES MOINES, IA 50309
Polk County (515) 241-6611
CENTRAL IOWA HOSPITAL CORPORATION
Rehabilitation Unit
1200 PLEASANT ST
DES MOINES, IA 50309
Polk County (515) 241-6212
DR. LISA I HARDISTY M.D.
Pediatrics
1200 PLEASANT ST
DES MOINES, IA 50309
Polk County (515) 241-5926
BROOKE JOHNSON D.O.
Emergency Medicine
1200 PLEASANT ST
DES MOINES, IA 50309
Polk County (515) 241-6262
JAMIE LYNN PIOTROWSKI NP-C
Nurse Practitioner
1200 PLEASANT ST
DES MOINES, IA 50309
Polk County (515) 524-1621
BILAL HASAN BAIG DO
Internal Medicine
1200 PLEASANT ST
DES MOINES, IA 50309
Polk County (515) 241-6636
HOLLEY A BZDEGA MD
Pediatrics (Neonatal-Perinatal Medicine)
1200 PLEASANT ST, NEONATOLOGY
DES MOINES, IA 50309
Polk County (515) 241-4444

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 Jack Davenport's NPI number?

The NPI number for Jack Davenport is 1699102301. It was assigned to this individual provider in the NPPES registry on September 27, 2013.

Where is Jack Davenport located?

Jack Davenport practices at 1200 Pleasant St, Des Moines, IA 50309. The listed phone number is (515) 241-6372.

What is Jack Davenport's specialty?

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

Is Jack Davenport enrolled in Medicare?

Yes. Jack Davenport is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Jack Davenport's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jack Davenport reassigns Medicare benefits to Associated Anesthesiologists, P.C. (Des Moines, IA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jack Davenport's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Jack Davenport affiliated with any hospitals?

According to CMS data, Jack Davenport is affiliated with Unitypoint Health - Des Moines Iowa Methodist Medi.

When was this NPI record last updated?

The NPPES record for Jack Davenport was last updated on June 26, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.