DR. EDDIE DEAN DAVENPORT (MD) – Cardiovascular Disease Physician, NPI 1962512210

DR. EDDIE DEAN DAVENPORT (MD) is a healthcare provider. based in Jbsa lackland, Texas. specializing in CARDIOVASCULAR DISEASE (CARDIOLOGY). They hold the professional credentials MD. They hold a License No. N3601 (TX). The NPI Number for DR. EDDIE DEAN DAVENPORT (MD) is 1962512210

Main info

Male
23 Years Of Experience
Accepts Medicare Assignment
Name
DR. EDDIE DEAN DAVENPORT (MD)
NPI
1962512210
Phone
(210) 292-6225
Address
1100 Wilford Hall Loop Bldg 4554
Enumeration Date
30 August 2006
Last Update Date
9 August 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9374388640
Graduation Year
2003 (23 years ago)
PAC ID
1254472491
Group Practice PAC ID
5597708594
Professional Enrollment ID
I20111117000429
Address ID
OH454092731DA122XXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience75
Completeness75
Years active:19State licenses:3Digital endpointsOther names

2,430 CARDIOVASCULAR DISEASE (CARDIOLOGY) in TX

Provider Addresses for DR. EDDIE DEAN DAVENPORT (MD)

  • 1100 Wilford Hall Loop Bldg 4554

    Jbsa Lackland, TX 78236

    Phone: (210) 292-6225

    Type: Location

  • 122 Wyoming St

    Dayton, OH 454092731

    Phone: (937) 223-4461

    Fax: (937) 449-7603

    Type: Location

  • Wright-Patterson Medical Center, 4881, Sugar Maple Drive, Buckeye Trailer Court, Greene County, Ohio, 45433, United States

    WRIGHT PATTERSON AFB, OH 454335529

    Phone: (937) 257-1558

    Type: Mailing

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: 2011-11-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20100109000110ICardiovascular Disease (Cardiology)TXTBD
I20111117000429ICardiovascular Disease (Cardiology)OHTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
93306Ultrasound of heart with color-depicted blood flow, rate, direction and valve function177176$0
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes2828$0
99233Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes2321$0
93356Heart muscle strain imaging1919$0
93308Ultrasound of heart, follow-up1717$0
View full utilization report →

Insurance plans in this area (ZIP 78236)

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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: 5597708594View full group profile
NameSpecialtyState
Hand Surgery, Orthopedic SurgeryOH
Physician AssistantOH
-OH
Cardiovascular Disease (Cardiology)OH
-OH
Physician AssistantOH
Thoracic SurgeryPA
Physician AssistantOH
Nurse PractitionerOH
Physician AssistantOH

Reviews

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Frequently asked questions

What is DR. EDDIE DEAN DAVENPORT (MD)'s NPI number?
DR. EDDIE DEAN DAVENPORT (MD)'s NPI is 1962512210 — the number used across U.S. healthcare to identify this provider.
Would DR. EDDIE DEAN DAVENPORT (MD) appear as active to a payer?
You can treat DR. EDDIE DEAN DAVENPORT (MD) as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with DR. EDDIE DEAN DAVENPORT (MD)?
DR. EDDIE DEAN DAVENPORT (MD)'s record emphasizes Cardiovascular Disease Physician. Clinical services aligned with this taxonomy classification.
Is DR. EDDIE DEAN DAVENPORT (MD) located near Jbsa Lackland?
DR. EDDIE DEAN DAVENPORT (MD) currently maps to Jbsa Lackland, Texas in this extract.
Does DR. EDDIE DEAN DAVENPORT (MD) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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