Jackson Davenport Vision, Inc.
NPI 1184719387ActiveOrganization· Optometrist· Summerville, SC
Optometrist in Summerville, South Carolina, registered in NPPES in October 2006. The authorized official on file is Kenneth Richard Davenport, President.
Overview
| NPI | 1184719387 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 4, 2006 |
| Last updated in NPPES | May 25, 2026 |
| Certified by provider | May 25, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Optometrist Primary | 152W00000X | — | — |
| Optometrist | 152W00000X | 589 | SC |
| Technician/Technologist, Optician | 156FX1800X | 686 | SC |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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