Provider Demographics
NPI:1104039650
Name:CAPITAL HEART ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:CAPITAL HEART ASSOCIATES, P.C.
Other - Org Name:NANCY J. DAVENPORT, M.D., P.C.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:J
Authorized Official - Last Name:DAVENPORT
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD, FACC
Authorized Official - Phone:202-686-9801
Mailing Address - Street 1:5215 LOUGHBORO RD NW
Mailing Address - Street 2:SUITE 460
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-2618
Mailing Address - Country:US
Mailing Address - Phone:202-686-9801
Mailing Address - Fax:202-363-6464
Practice Address - Street 1:5215 LOUGHBORO RD NW
Practice Address - Street 2:SUITE 460
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-2618
Practice Address - Country:US
Practice Address - Phone:202-686-9801
Practice Address - Fax:202-363-6464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2014-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD18999207RC0000X, 207RI0011X
DCMD25545207RC0000X
DCPA030947363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCCC1952OtherRR MEDICARE
DCCC1952OtherRR MEDICARE
DCC62798Medicare UPIN
DCE90642Medicare UPIN
296051ZBZ9Medicare PIN
677576CO6Medicare PIN
445798ZBZ9Medicare PIN