Colin Deane Davenport
Colin Deane Davenport is a Nurse Practitioner in Indianapolis, Indiana. Qualified in 2024, 2 years ago. Practices with My Mobile MD LLC, a 27-clinician group and accepts Medicare assignment. Licensed in Indiana.
- Years since qualifying
- 2
- Licensed in
- IN
- In the registry since
- 2023
- Specialties on file
- 2
Practice location Address checks out
429 E Vermont St Ste 110Indianapolis, IN 46202-3685
Phone: (317) 559-0950
Fax: (317) 936-3028
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Nurse Practitioner (primary) | Taxonomy 363L00000X · Licence 71016312A (IN) |
|---|---|
| Adult Medicine Physician | Taxonomy 207QA0505X · Licence 71016312A (IN) |
Record details
| NPI number | 1598545360 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | September 29, 2023 |
| Last updated in NPPES | July 20, 2026 |
| Certification date | July 20, 2026 |
| Mailing address | Po Box 586, Galloway, OH 43119-0586 |
Medicare enrollment
| Medicare specialty | NURSE PRACTITIONER |
|---|---|
| Medical school | OTHER |
| Graduated | 2024 (2 years in practice) |
| Group practice | My Mobile Md Llc — 27 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Practice locations | 2 on file with Medicare |
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