Davenport Clinic – Rural Health Clinic/Center, NPI 1558309518

Davenport Clinic is a healthcare provider. based in Davenport, Washington. specializing in Rural Health Clinic/Center. The organization holds a License No. H-137 (WA). The NPI Number for Davenport Clinic is 1558309518

Main info

Organization
Name
Davenport Clinic
NPI
1558309518
Phone
(509) 725-7501
Address
10 NICHOLLS ST
Authorized Official
TYSON LACY CEO
Enumeration Date
3 June 2006
Last Update Date
26 February 2026
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience74
Completeness90
Years active:20State licenses:1Digital endpoints

Provider Addresses for Davenport Clinic

  • 10 NICHOLLS ST

    DAVENPORT, WA 991229729

    Phone: (509) 725-7501

    Fax: (509) 725-7504

    Type: Mailing

  • 100, 3rd Street, Davenport, Cass County, North Dakota, 58021, United States

    SUITE 1

    DAVENPORT, WA 991229730

    Phone: (509) 725-7501

    Fax: (509) 725-7504

    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: 2008-05-12

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
O20080512000261ORural Health ClinicWATBD

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 99122)

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Reviews

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Frequently asked questions

Can I verify Davenport Clinic with an NPI only?
You can start verification with NPI 1558309518 for Davenport Clinic, then check state licensing separately.
Does the file indicate Davenport Clinic is practicing under active NPI?
Directory data currently reports Davenport Clinic as active.
What is Davenport Clinic's primary classification?
Rural Health Clinic/Center is the headline specialty for Davenport Clinic here. Clinical services aligned with this taxonomy classification.
Where is Davenport Clinic based?
Davenport Clinic is tied to Davenport, Washington in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
4 practice locations appear in the available data.

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