Samuel V Davenport, CRNA - Medicare Nurse Anesthetist, Certified Registered in Johnson City, TN

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Samuel V Davenport, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Johnson City, Tennessee. His current practice location is 400 N State Of Franklin Rd, Johnson City, Tennessee. You can reach out to his office (for appointments etc.) via phone at (423) 431-6111.

Samuel V Davenport is licensed to practice in Tennessee (license number RN0000104846) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1083616056.

Contact Information

Samuel V Davenport, CRNA
400 N State Of Franklin Rd,
Johnson City, TN 37604-6035
(423) 431-6111
Not Available

Map and Direction




Provider's Profile

Full NameSamuel V Davenport
GenderMale
SpecialityNurse Anesthetist, Certified Registered
Location400 N State Of Franklin Rd, Johnson City, Tennessee
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1083616056
  • Provider Enumeration Date: 08/10/2005
  • Last Update Date: 04/24/2019
  Medicare PECOS Information:
  • PECOS PAC ID: 0042408932
  • Enrollment ID: I20101220000174

Medical Identifiers

Medical identifiers for Samuel V Davenport such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1083616056NPI-NPPES
3631202MedicaidTN

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
367500000XNurse Anesthetist, Certified Registered RN0000104846 (Tennessee)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Samuel V Davenport allows following entities to bill medicare on his behalf.
Entity NameAnesthesia And Pain Consultants Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1750399127
PECOS PAC ID: 1355239385
Enrollment ID: O20040310000239
Entity NameParagon Anesthesia Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1538174974
PECOS PAC ID: 8921044744
Enrollment ID: O20090402000626

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Samuel V Davenport is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Samuel V Davenport, CRNA
1009 Lark St Ste 2,
Johnson City, TN 37604-8218

Ph: (423) 283-0776		Samuel V Davenport, CRNA
400 N State Of Franklin Rd,
Johnson City, TN 37604-6035

Ph: (423) 431-6111

Reviews and Comments


Nurse Anesthetist, Certified Registered Nurses in Johnson City, TN

Shawn D Bright, CRNA
Nurse Anesthetist - CR
Medicare: Medicare Enrolled
Practice Location: 1009 Novus Dr Ste 2, Johnson City, TN 37604
Phone: 423-283-0776    Fax: 423-283-0549
Lisa W Green, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 1009 Lark St, Suite 2, Johnson City, TN 37604
Phone: 423-283-0776    Fax: 423-283-0549
Marcos D Demoura, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 818 Sunset Dr Ste 103, Johnson City, TN 37604
Phone: 423-794-3142    
Chasity A Huffman, RN
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 1009 Novus Dr Ste 2, Johnson City, TN 37604
Phone: 423-283-0776    Fax: 423-968-5697
Mrs. Jewel B Welch, CRNAP
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 1009 Novus Dr, Johnson City, TN 37604
Phone: 423-283-0776    
Johnny Lee Estep, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 1009 Novus Dr, Johnson City, TN 37604
Phone: 423-282-0776    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.