Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Colin Deane Davenport

Individual provider Adult Medicine Physician · NPI 1598545360

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 110
Indianapolis, IN 46202-3685
Phone: (317) 559-0950
Fax: (317) 936-3028
Show map & directions

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 number1598545360
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 29, 2023
Last updated in NPPESJuly 20, 2026
Certification dateJuly 20, 2026
Mailing addressPo Box 586, Galloway, OH 43119-0586

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice My Mobile Md Llc — 27 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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