Devona L. Fagan, N.P.

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

17793 Issued in CA

Practice address

895 Adams Blvd
Boulder City, NV 89005-2235

Phone

(702) 293-0406

Fax

(702) 293-0192

NPI assigned

Sep 23, 2008

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GCCCCA/Endpoint/GCCCCA

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jim C Chiang MD LTD

  • Family Medicine Physician
  • Boulder City, NV
  • NPI 1710161518
  Medicare reassignment NPD
• Herve Bezard MD LTD

  • Family Medicine Physician
  • Boulder City, NV
  • NPI 1699959494
  NPD
• Sally Nahhas DO LTD

  • Family Medicine Physician
  • Boulder City, NV
  • NPI 1831917293
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1222128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1013167402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "895 ADAMS BLVD",
            "city": "BOULDER CITY",
            "state": "NV",
            "postal_code": "890052235",
            "telephone_number": "702-293-0406",
            "fax_number": "702-293-0192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "895 ADAMS BLVD",
            "city": "BOULDER CITY",
            "state": "NV",
            "postal_code": "890052235",
            "telephone_number": "702-293-0406",
            "fax_number": "702-293-0192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGAN",
        "first_name": "DEVONA",
        "middle_name": "L.",
        "name_prefix": "Mrs.",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-23",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "CA",
            "license": "NP17793",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "17793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debbie Effert
• Megan English-Young
• Rhonda Erlo
• Sarah Estes
• Excellence Health Consulting LLC
• Michael Falvo, DO
• Family Connection
• Family Doctors of Boulder City
• Julie Ferguson
• Tiffany Jean Field

• Acute Care Nurse Practitioner in Boulder City, NV
• Providers in Boulder City, NV by specialty
• Acute Care Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.