MIKE S DAVENPORT (FNP) – Family Medicine Physician, NPI 1295789576
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
11,632 NURSE PRACTITIONER in IL
Provider Addresses for MIKE S DAVENPORT (FNP)
208 S WASHINGTON ST
MC LEANSBORO, IL 628591139
Phone: (618) 643-2835
Type: Mailing
206 S WASHINGTON ST
MC LEANSBORO, IL 628591139
Phone: (618) 643-2835
Fax: (618) 643-2891
Type: Location
208, South Washington Street, McLeansboro, Hamilton County, Illinois, 62859, United States
MCLEANSBORO, IL 628591139
Phone: (618) 643-2835
Fax: (618) 643-2891
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 30 Open Payments records for all available years, with a total value of $674.
Total Amount is formed as General ($674) + Research ($0) + Ownership ($0) = $674.
Last reported payment date: 2024-03-21 • Largest payer in this snapshot: Lilly USA, LLC ($190).
Total Amount
$674
General + Research + Ownership
Payments
30
Total payment records
General Amount
$674
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-03-21
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Lilly USA, LLC | $190 |
| AstraZeneca Pharmaceuticals LP | $185 |
| Novo Nordisk Inc | $168 |
| Amgen Inc. | $99 |
| Exact Sciences Corporation | $32 |
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: 2005-12-22
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20051222000477 | I | Nurse Practitioner | IL | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 81002 | Urinalysis, manual test | 18 | 14 | $0 |
Insurance plans in this area (ZIP 62859)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | IN | |
| Emergency Medicine | IL | |
| Emergency Medicine | IL | |
| Internal Medicine, Emergency Medicine, Emergency Medicine, Internal Medicine | CO | |
| Family Practice | IN | |
| Family Practice, Family Practice, Emergency Medicine, Hospitalist | IN |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.