MADDALENA DAVENPORT (APRN) – Family Nurse Practitioner, NPI 1154157808

MADDALENA DAVENPORT (APRN) is a healthcare provider. based in Ladd, Illinois. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN. They hold a License No. 209030516 (IL). The NPI Number for MADDALENA DAVENPORT (APRN) is 1154157808

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
MADDALENA DAVENPORT (APRN)
NPI
1154157808
Phone
(815) 303-7652
Address
918 E CLEVELAND ST
Enumeration Date
10 September 2024
Last Update Date
13 September 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8155392663
Graduation Year
2024 (2 years ago)
PAC ID
5890236228
Group Practice PAC ID
2264335777
Professional Enrollment ID
I20240925001073
Address ID
IL613429010ME1405XSTXX405
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

11,637 NURSE PRACTITIONER in IL

Provider Addresses for MADDALENA DAVENPORT (APRN)

  • 918 E CLEVELAND ST

    LADD, IL 613299720

    Phone: (815) 303-7652

    Type: Mailing

  • 401 N MAIN ST

    ROANOKE, IL 615617585

    Phone: (309) 923-2661

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2024-09-25

PECOS data refreshed: 2026-05-27

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
I20240925001073INurse PractitionerILTBD

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 61329)

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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: 2264335777View full group profile
NameSpecialtyState
Nurse PractitionerIL
Internal MedicineIL
Nurse PractitionerIL
Physician AssistantIL
Nurse PractitionerIL
Family PracticeIL
Family PracticeIL
Family PracticeWI
Nurse PractitionerIL
Nurse PractitionerIL

Reviews

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Frequently asked questions

Does MADDALENA DAVENPORT (APRN) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — MADDALENA DAVENPORT (APRN) uses 1154157808.
Is MADDALENA DAVENPORT (APRN) listed as active for patients and plans?
The listing shows MADDALENA DAVENPORT (APRN) as active in the NPI system.
What taxonomy line describes MADDALENA DAVENPORT (APRN)?
For research purposes, treat MADDALENA DAVENPORT (APRN) as Family Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.
Does MADDALENA DAVENPORT (APRN) list a practice location?
Patients near Ladd, Illinois may find MADDALENA DAVENPORT (APRN) in results; validate coverage separately.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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