Active NPI 1346484581 Individual Practitioner Male Practitioner

Dr. Derek Joseph Davenport , MD

Pediatrics • Eagle Mountain, UT

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Derek Davenport, MD is a certified Pediatrics practicing in Eagle Mountain, UT. With approximately 17 years of clinical experience since completing medical education in 2009, Dr. Davenport delivers high-quality medical care to the local community at 4095 E PONY EXPRESS PKWY STE 1.

Dr. Davenport is affiliated with Revere Health Pc and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, insertion of needle into vein for collection of blood sample, visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

4095 E Pony Express Pkwy Ste 1

Eagle Mountain, UT 840055531

Telephone 8014298037

Fax 8017537476

Associated Practice Facility / Clinic

🏢 No Roll Up Timpanogos Llc Facility NPI 1831153840

Medicare Profile & Education

Medical School

Other

Graduation Year

2009

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Eagle Mountain, UT

Established Specialist (10-20 Yrs)

Practitioner Clinical Experience

17 Yrs Matches City Avg

City Avg: 17.0 Yrs

State Avg: 21.9 Yrs

Regional Practice Density

3 Specialists

Practicing in Eagle Mountain, UT (688 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

37.8% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Davenport (17 Years) 17 Yrs

Eagle Mountain Specialty Average (17.0 Years) 17.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	226	101	$215.61	$119.04
36415 Insertion of needle into vein for collection of blood sample	184	100	$15.86	$8.65
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's	165	88	$33.47	$15.31
80053 Blood test, comprehensive group of blood chemicals	154	97	$22.88	$10.35
83036 Hemoglobin A1C level	135	67	$21.00	$9.45
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	128	84	$13.88	$7.61
80061 Blood test, lipids (cholesterol and triglycerides)	121	82	$28.00	$13.12
84443 Blood test, thyroid stimulating hormone (TSH)	98	62	$35.90	$16.46
82043 Urine microalbumin (protein) level	77	47	$13.00	$5.66
82570 Creatinine level to test for kidney function or muscle injury	77	47	$9.00	$5.08
82607 Cyanocobalamin (vitamin B-12) level	62	45	$32.00	$14.78
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	56	56	$191.00	$123.01
82306 Vitamin d-3 level	48	38	$62.00	$29.01
G0008 Administration of influenza virus vaccine	39	39	$19.00	$18.14
83970 Parathormone (parathyroid hormone) level	35	23	$87.00	$40.45
90662 Influenza vaccine split virus, preservative free	35	35	$98.00	$79.48
84439 Thyroxine (thyroid chemical), free	33	25	$19.00	$8.84
84100 Phosphate level	24	17	$10.00	$4.65
80048 Blood test, basic group of blood chemicals (calcium, total)	16	14	$18.00	$8.29
G0009 Administration of pneumococcal vaccine	11	11	$19.00	$18.62
90677 Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use	11	11	$397.18	$290.41

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	244	110	$211.58	$120.62
36415 Insertion of needle into vein for collection of blood sample	185	100	$14.43	$8.40
80053 Blood test, comprehensive group of blood chemicals	146	97	$22.20	$10.35
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	126	87	$13.19	$7.61
80061 Blood test, lipids (cholesterol and triglycerides)	114	83	$28.00	$13.12
83036 Hemoglobin A1C level	114	64	$19.60	$9.52
84443 Blood test, thyroid stimulating hormone (TSH)	106	73	$35.19	$16.46
82570 Creatinine level to test for kidney function or muscle injury	77	51	$9.00	$5.08
82043 Urine microalbumin (protein) level	77	51	$13.00	$5.66
82607 Cyanocobalamin (vitamin B-12) level	63	47	$32.00	$14.78
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	54	54	$191.00	$122.56
82306 Vitamin d-3 level	46	35	$62.00	$29.01
G0008 Administration of influenza virus vaccine	45	45	$19.00	$18.62
90662 Influenza vaccine split virus, preservative free	39	39	$101.00	$71.93
84439 Thyroxine (thyroid chemical), free	29	21	$19.00	$8.84
83970 Parathormone (parathyroid hormone) level	27	21	$87.00	$40.45
80048 Blood test, basic group of blood chemicals (calcium, total)	26	17	$18.00	$8.29
99213 Established patient office or other outpatient visit, typically 15 minutes	26	25	$149.69	$85.98
84100 Phosphate level	23	16	$10.00	$4.65
82728 Ferritin (blood protein) level	13	12	$29.00	$13.36
G0009 Administration of pneumococcal vaccine	13	13	$19.00	$18.62
90677 Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use	13	13	$409.00	$281.03

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	264	110	$208.91	$121.64
80053 Blood test, comprehensive group of blood chemicals	151	94	$23.00	$10.33
36415 Insertion of needle into vein for collection of blood sample	142	88	$10.00	$2.93
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	107	78	$14.00	$7.69
80061 Blood test, lipids (cholesterol and triglycerides)	94	74	$28.00	$13.15
84443 Blood test, thyroid stimulating hormone (TSH)	89	63	$36.00	$16.48
83036 Hemoglobin A1C level	84	45	$18.95	$9.52
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	63	63	$192.11	$125.36
82043 Urine microalbumin (protein) level	48	37	$13.15	$5.64
82570 Creatinine level to test for kidney function or muscle injury	47	37	$9.00	$5.05
82607 Cyanocobalamin (vitamin B-12) level	44	40	$32.00	$14.95
82306 Vitamin d-3 level	38	34	$62.00	$28.67
G0008 Administration of influenza virus vaccine	37	36	$19.00	$18.15
99213 Established patient office or other outpatient visit, typically 15 minutes	32	25	$148.00	$84.64
90662 Influenza vaccine split virus, preservative free	30	30	$94.00	$66.26
83970 Parathormone (parathyroid hormone) level	25	22	$87.00	$40.92
84100 Phosphate level	22	17	$10.00	$4.70
84439 Thyroxine (thyroid chemical), free	21	17	$19.00	$8.91
82728 Ferritin (blood protein) level	17	14	$29.00	$13.49
87635 Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen	13	13	$88.00	$50.68
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	12	12	$286.50	$161.46

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	180	89	$206.72	$123.74
36415 Insertion of needle into vein for collection of blood sample	112	71	$10.00	$2.95
80053 Blood test, comprehensive group of blood chemicals	102	63	$23.00	$10.56
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	69	50	$14.20	$7.66
80061 Blood test, lipids (cholesterol and triglycerides)	67	54	$28.00	$13.39
84443 Blood test, thyroid stimulating hormone (TSH)	64	41	$36.00	$16.80
83036 Hemoglobin A1C level	57	32	$21.00	$9.71
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	44	44	$205.68	$127.70
82570 Creatinine level to test for kidney function or muscle injury	36	23	$9.33	$5.18
82043 Urine microalbumin (protein) level	36	23	$14.00	$5.78
82607 Cyanocobalamin (vitamin B-12) level	35	25	$32.00	$15.08
82306 Vitamin d-3 level	21	18	$62.00	$29.60
84439 Thyroxine (thyroid chemical), free	21	19	$19.00	$9.02
G0008 Administration of influenza virus vaccine	21	21	$19.00	$16.15
90694 Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage	21	21	$100.00	$66.43
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	17	17	$281.00	$162.55
83970 Parathormone (parathyroid hormone) level	12	11	$87.00	$41.28

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	201	96	$196.48	$103.62
80053 Blood test, comprehensive group of blood chemicals	91	69	$22.97	$10.54
36415 Insertion of needle into vein for collection of blood sample	91	68	$10.00	$2.99
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	73	59	$15.97	$7.75
84443 Blood test, thyroid stimulating hormone (TSH)	56	46	$35.96	$16.76
99213 Established patient office or other outpatient visit, typically 15 minutes	47	35	$134.49	$70.61
80061 Blood test, lipids (cholesterol and triglycerides)	45	41	$28.00	$13.34
83036 Hemoglobin A1C level	37	26	$20.95	$9.69
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	26	26	$211.00	$108.42
82607 Cyanocobalamin (vitamin B-12) level	19	16	$31.95	$15.05
82570 Creatinine level to test for kidney function or muscle injury	18	18	$10.89	$5.16
82043 Urine microalbumin (protein) level	18	18	$13.89	$5.76
81003 Automated urinalysis test	18	15	$6.94	$2.24
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	17	12	$43.00	$13.84
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	15	15	$196.07	$105.30
84439 Thyroxine (thyroid chemical), free	14	11	$19.00	$8.99

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
85610 Blood test, clotting time	225	80	$9.00	$4.28
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	216	80	$61.00	$22.42
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	97	56	$304.00	$107.41
36415 Insertion of needle into vein for collection of blood sample	84	54	$11.00	$2.90
99213 Established patient office or other outpatient visit, typically 15 minutes	54	37	$206.00	$71.77
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	32	24	$18.00	$8.46
80053 Blood test, comprehensive group of blood chemicals	30	23	$24.00	$11.51
84443 Blood test, thyroid stimulating hormone (TSH)	28	23	$39.00	$18.30
G0008 Administration of influenza virus vaccine	25	25	$70.00	$16.19
80061 Blood test, lipids (cholesterol and triglycerides)	25	24	$31.00	$14.58
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	23	23	$331.00	$115.25
83036 Hemoglobin A1C level	22	18	$22.00	$10.57
90662 Influenza vaccine split virus, preservative free	20	20	$75.00	$54.89
80048 Blood test, basic group of blood chemicals (calcium, total)	17	12	$20.00	$9.21
84439 Thyroxine (thyroid chemical), free	17	15	$21.00	$9.82
82570 Creatinine level to test for kidney function or muscle injury	12	11	$12.00	$5.63
82042 Cerebrospinal fluid, or amniotic fluid albumin (protein) level	12	11	$12.00	$7.62

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
85610 Blood test, clotting time	222	79	$9.00	$4.75
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	211	77	$57.00	$21.08
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	105	60	$303.00	$104.75
36415 Insertion of needle into vein for collection of blood sample	85	55	$11.00	$2.94
99213 Established patient office or other outpatient visit, typically 15 minutes	51	39	$206.00	$71.47
83036 Hemoglobin A1C level	30	21	$22.00	$11.75
80061 Blood test, lipids (cholesterol and triglycerides)	28	28	$31.00	$16.20
80053 Blood test, comprehensive group of blood chemicals	28	26	$24.00	$12.78
G0008 Administration of influenza virus vaccine	26	26	$70.00	$19.92
90662 Influenza vaccine split virus, preservative free	24	24	$69.00	$52.30
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	22	22	$328.00	$114.00
84443 Blood test, thyroid stimulating hormone (TSH)	20	17	$39.00	$20.33
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	19	18	$18.00	$9.40
80048 Blood test, basic group of blood chemicals (calcium, total)	16	14	$20.00	$10.23
84439 Thyroxine (thyroid chemical), free	14	12	$21.00	$10.91

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
85610 Blood test, clotting time	393	133	$9.00	$5.28
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	381	135	$56.00	$19.64
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	138	69	$302.00	$104.30
36415 Insertion of needle into vein for collection of blood sample	122	64	$11.00	$2.88
80053 Blood test, comprehensive group of blood chemicals	48	38	$24.00	$11.86
99213 Established patient office or other outpatient visit, typically 15 minutes	44	32	$205.00	$71.02
80048 Blood test, basic group of blood chemicals (calcium, total)	40	23	$20.00	$10.81
G0008 Administration of influenza virus vaccine	36	34	$70.00	$24.61
80061 Blood test, lipids (cholesterol and triglycerides)	36	35	$31.00	$14.31
83036 Hemoglobin A1C level	34	23	$22.00	$13.05
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	31	31	$327.00	$112.51
84443 Blood test, thyroid stimulating hormone (TSH)	28	21	$39.00	$22.59
90662 Influenza vaccine split virus, preservative free	24	24	$60.00	$48.05
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	22	20	$18.00	$10.06
85027 Complete blood cell count (red cells, white blood cell, platelets), automated test	15	15	$15.00	$8.69
84439 Thyroxine (thyroid chemical), free	14	12	$21.00	$12.12
82042 Cerebrospinal fluid, or amniotic fluid albumin (protein) level	12	11	$12.00	$6.96
82570 Creatinine level to test for kidney function or muscle injury	12	11	$12.00	$6.96

Medical Specialties & State Licenses

CMS Verified: 2020-06-02

Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License UT 11327523-1205

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Internal Medicine

NUCC Taxonomy Code: 207R00000X

State License UT 11327523-1205

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Internal Medicine

NUCC Taxonomy Code: 207R00000X

State License OR MD162235

Pediatrics

NUCC Taxonomy Code: 208000000X

State License OR MD162235

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

500659989 (OR)

Commercial Insurance / Payer ID Npi

1346484581

Hospital & Practice Group Affiliations

Revere Health Pc

4095 E Pony Express Pkwy, Eagle Mountain, UT 840055531

Phone: 8014298037

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

15 Associated Practitioners

Paul Lewis , NP

Nurse Practitioner - Family

NPI 1093263220

Nurse Practitioner

Lorin Leithead , APRN

Nurse Practitioner - Family

NPI 1164852745

Advanced Practice Registered Nurse

Rachael Clark

Dietitian, Registered

NPI 1194403865

Kelsie Beddes , FNP

Nurse Practitioner - Family

NPI 1275250235

Family Nurse Practitioner

Tyson Roberts , PA

Physician Assistant

NPI 1346137726

Physician Assistant

Brian Pontius , MPAS PA-C

Physician Assistant

NPI 1356869879

MPASPAC

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) November 27, 2023

Internal Medicine (License #11327523-1205 in UT)

📍

Updated Practice Location March 11, 2020

Registered at 4095 E PONY EXPRESS PKWY STE 1, EAGLE MOUNTAIN, UT 840055531 (Tel: 8014298037)

📍

Updated Business Mailing Address March 11, 2020

Registered at 1055 N 500 W, ATTN. CREDENTIALING, PROVO, UT 84604 (Tel: 8013548225)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) March 11, 2020

Internal Medicine (License #MD162235 in OR)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) October 02, 2019

Internal Medicine (License #11327523-1205 in UT)

✅

NPI Profile Active January 14, 2014

NPI status registered as active in NPPES database

📍

Updated Practice Location January 14, 2014

Registered at 4135 QUEST DR, EUGENE, OR 974028768 (Tel: 5414618006)

📍

Updated Business Mailing Address January 14, 2014

Registered at PO BOX 1648, EUGENE, OR 974401648 (Tel: 5414618006)

👤

Provider Name / Credentials Updated January 14, 2014

Recorded as DEREK DAVENPORT, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) January 14, 2014

Internal Medicine (License #MD162235 in OR)

🟢

Initial NPI Registration & Enumeration April 30, 2009

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1346484581

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: April 30, 2009

Last Update: November 27, 2023

Sole Proprietor: No

Update or Correct Profile

Mailing Address

1055 N 500 W, Attn. Credentialing

Provo, UT 84604

Phone: 8013548225

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.