Ian Deville

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

16763 Issued in TN

Practice address

5842 Highway 30
Benton, TN 37307-4734

Phone

(423) 283-5533

NPI assigned

Jun 29, 2026

Sex

Male

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 29, 2026.

{
    "created_epoch": "1782691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1013833367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5842 HIGHWAY 30",
            "city": "BENTON",
            "state": "TN",
            "postal_code": "373074734",
            "telephone_number": "423-241-3935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5842 HIGHWAY 30",
            "city": "BENTON",
            "state": "TN",
            "postal_code": "373074734",
            "telephone_number": "423-283-5533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVILLE",
        "first_name": "IAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-06-29",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "16763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Change Academy at Lake of the Ozarks
• Change Academy at Lake of the Ozarks
• Change Academy at Lake of the Ozarks
• Bryan Curtis Clary, DPT
• Scott A Cline, RPH
• Stephanie Lynn Edwards, RN, MSN
• Karalyn Morgan Fallin, RN, BSN
• Susan G Fisher, MD
• Joseph Matthew Gager, P.T.
• Benjamin Geyman

• All providers in Benton, TN
• Clinical Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.