MRS. SHELLY MARIE DAVENPORT (MS, LMFT) – Marriage & Family Therapist, NPI 1134166275

MRS. SHELLY MARIE DAVENPORT (MS, LMFT) is a healthcare provider. based in Champlin, Minnesota. specializing in MARRIAGE AND FAMILY THERAPIST. They hold the professional credentials MS, LMFT. They hold a License No. 1139 (MN). The NPI Number for MRS. SHELLY MARIE DAVENPORT (MS, LMFT) is 1134166275

Main info

Female
29 Years Of Experience
Accepts Medicare Assignment
Name
MRS. SHELLY MARIE DAVENPORT (MS, LMFT)
NPI
1134166275
Phone
(763) 951-3091
Address
11141 ZEALAND AVE N
Enumeration Date
31 May 2006
Last Update Date
18 May 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7639513091
Graduation Year
1997 (29 years ago)
PAC ID
2961655162
Group Practice PAC ID
4284887472
Professional Enrollment ID
I20231218002583
Address ID
MN553163595CH11141NXXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

981 MARRIAGE AND FAMILY THERAPIST in MN

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Provider Addresses for MRS. SHELLY MARIE DAVENPORT (MS, LMFT)

  • 11141, Zealand Avenue North, Champlin, Hennepin County, Minnesota, 55316, United States

    CHAMPLIN, MN 553163595

    Phone: (763) 951-3091

    Fax: (763) 951-3097

    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)

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: 2023-12-18

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
I20231218002583IMarriage And Family TherapistMNTBD

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 55316)

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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: 4284887472View full group profile
NameSpecialtyState
-MN
Marriage And Family TherapistMN
-MN
Mental Health CounselorMN
Marriage And Family TherapistMN
Mental Health CounselorMN

Reviews

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Frequently asked questions

Can I verify MRS. SHELLY MARIE DAVENPORT (MS, LMFT) with an NPI only?
You can start verification with NPI 1134166275 for MRS. SHELLY MARIE DAVENPORT (MS, LMFT), then check state licensing separately.
Is MRS. SHELLY MARIE DAVENPORT (MS, LMFT) still practicing?
MRS. SHELLY MARIE DAVENPORT (MS, LMFT) is currently listed as active in the public NPI registry.
What taxonomy line describes MRS. SHELLY MARIE DAVENPORT (MS, LMFT)?
For research purposes, treat MRS. SHELLY MARIE DAVENPORT (MS, LMFT) as Marriage & Family Therapist in this dataset. Clinical services aligned with this taxonomy classification.
Does MRS. SHELLY MARIE DAVENPORT (MS, LMFT) list a practice location?
Patients near Champlin, Minnesota may find MRS. SHELLY MARIE DAVENPORT (MS, LMFT) in results; validate coverage separately.
Is the information about MRS. SHELLY MARIE DAVENPORT (MS, LMFT) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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