MELISSA M DAVENPORT (PA) – Medical Physician Assistant, NPI 1538425822

MELISSA M DAVENPORT (PA) is a healthcare provider. based in Rigby, Idaho. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. The NPI Number for MELISSA M DAVENPORT (PA) is 1538425822

Main info

Female
15 Years Of Experience
Accepts Medicare Assignment
Name
MELISSA M DAVENPORT (PA)
NPI
1538425822
Phone
(208) 745-8747
Address
167 E 1ST S
Enumeration Date
11 April 2012
Last Update Date
11 April 2012

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2085521234
Graduation Year
2011 (15 years ago)
PAC ID
2163688169
Group Practice PAC ID
4486562774
Professional Enrollment ID
I20120719000002
Address ID
ID834047407ID2375XSTXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience33
Completeness75
Years active:14State licenses:0Digital endpointsOther names

1,546 PHYSICIAN ASSISTANT in ID

Provider Addresses for MELISSA M DAVENPORT (PA)

  • 167 E 1ST S

    RIGBY, ID 83442

    Phone: (208) 745-8747

    Fax: (208) 745-9396

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 6 Open Payments records for all available years, with a total value of $107.

Total Amount is formed as General ($107) + Research ($0) + Ownership ($0) = $107.

Last reported payment date: 2024-10-25 • Largest payer in this snapshot: ABBVIE INC. ($34).

Total Amount

$107

General + Research + Ownership

Payments

6

Total payment records

General Amount

$107

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-25

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2012-07-19

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20120719000002IPhysician AssistantIDTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 83442)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4486562774View full group profile
NameSpecialtyState
Physician AssistantID
Family PracticeIL
P A T H O L O G YTX
-ID
Certified Registered Nurse Anesthetist (Crna)ID
Osteopathic Manipulative MedicineWY
Physician AssistantID
Physician AssistantID
Physical Medicine And RehabilitationID
Nurse PractitionerTX

Reviews

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Frequently asked questions

What identifier follows MELISSA M DAVENPORT (PA) across health systems?
The NPI 1538425822 uniquely identifies MELISSA M DAVENPORT (PA) in U.S. healthcare data.
Does the public listing show MELISSA M DAVENPORT (PA) as active?
MELISSA M DAVENPORT (PA)'s NPI record reflects an active status in NPPES.
What type of care does MELISSA M DAVENPORT (PA) provide?
MELISSA M DAVENPORT (PA)'s profile centers on Medical Physician Assistant. Clinical services aligned with this taxonomy classification.
Which community is linked to MELISSA M DAVENPORT (PA)?
MELISSA M DAVENPORT (PA) shows a connection to Rigby, Idaho in registry-derived data.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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