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ELISSA JO DAVENPORT NP
NPI 1962824375
Nurse Practitioner - Pediatrics in Caledonia, MI

Active since January 21, 2014PECOS Enrolled
8941 N RODGERS CT SE, CALEDONIA, MI 49316(616) 252-5300(616) 252-5390 Get Directions Write a Review

NPPES record last updated: February 5, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Feb 5, 2019, Dec 7, 2017, Feb 17, 2017 (3 updates tracked since 2017).

About Elissa Jo Davenport Np NPPES

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

ELISSA JO DAVENPORT NP (NPI 1962824375) is an individual pediatrics provider in Caledonia, Michigan, licensed in Michigan (4704260086) and active in the NPI registry since January 2014. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1962824375
Entity TypeIndividualFemale
Primary Taxonomy363LP0200X
Provider Legal NameELISSA JO DAVENPORTCredential: NP
Location Address8941 N RODGERS CT SECaledonia, MI 49316-8013
Mailing Address5900 Byron Center Ave Sw, Medical AdministrationWyoming, MI 49519-9606 · (616) 252-3243 · Fax (616) 252-0260
Phone(616) 252-5300
Fax(616) 252-5390
Sole ProprietorNo
Enumeration DateJanuary 21, 2014
Last NPPES UpdateFebruary 5, 20193 updates tracked since enumeration
✔ NPI 1962824375 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
License✔ Licensed in MI · 4704260086
8941 N RODGERS CT SE, Caledonia, MI 49316
Open in Google Maps ↗

Other Names 1

Former Name (1)Elissa Jo Stier Np

Other Identifiers 1

Other4704260086MI · State License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Priority Health, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Elissa Jo Davenport Np 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.

Medicare Billing Reassignment

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

Metropolitan Hospital
9.7 mi
Family Medicine
781 36TH ST SE
Wyoming, MI 49548
  • Reassigned Medicare billing, Michigan enrollment
  • 685 clinicians in this Medicare group
NPI 1114947538 (616) 252-4100

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49316 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
$84.74 typical visit price
range $54.34 – $166.68
Typical copayment $21.18 (range $13.58 – $41.67)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.09 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
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 15

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

JULIE STINTON
Nurse Practitioner
8941 N RODGERS CT SE
CALEDONIA, MI 49316
Kent County (616) 252-5300
ERIC SHANKIN
Internal Medicine
8941 N RODGERS CT SE
CALEDONIA, MI 49316
Kent County (616) 252-5300
TERRI ROSEL NP
Nurse Practitioner
8941 N RODGERS CT SE
CALEDONIA, MI 49316
Kent County (616) 252-5300
METRO WEEKEND CARE SERVICES, LLC
Clinic/Center (Urgent Care)
8941 N RODGERS CT SE
CALEDONIA, MI 49316
Kent County (616) 252-5300
ARYN JOHNSON DO
Family Medicine (Sports Medicine)
8941 N RODGERS CT SE
CALEDONIA, MI 49316
Kent County (616) 252-5300
TRACY JENSEN
Family Medicine
8941 N RODGERS CT SE
CALEDONIA, MI 49316
Kent County (517) 364-5710
LAURA S BOUCH D.O.
Pediatrics
8941 N RODGERS CT SE
CALEDONIA, MI 49316
Kent County (616) 252-5300
VALERIE KLOOSTERMAN PAC
Physician Assistant
8941 N RODGERS CT SE
CALEDONIA, MI 49316
Kent County (616) 252-5300

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 Elissa Davenport's NPI number?

The NPI number for Elissa Davenport is 1962824375. It was assigned to this individual provider in the NPPES registry on January 21, 2014. The provider is also known as Elissa Jo Stier Np.

Where is Elissa Davenport located?

Elissa Davenport practices at 8941 N Rodgers Ct SE, Caledonia, MI 49316. The listed phone number is (616) 252-5300.

What is Elissa Davenport's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Is Elissa Davenport enrolled in Medicare?

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

Which organization bills Medicare for Elissa Davenport's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Elissa Davenport reassigns Medicare benefits to Metropolitan Hospital (Wyoming, MI). 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 Elissa Davenport's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Elissa Davenport accept?

Health plans from Priority Health and UnitedHealthcare list Elissa Davenport as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Elissa Davenport was last updated on February 5, 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.