Theresa Eileen Deveaux, CRNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

R093166 Issued in MD

Practice address

301 Hospital Dr
Glen Burnie, MD 21061-5803

Phone

(410) 553-8300

Fax

(410) 553-8349

NPI assigned

Jun 2, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1117670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468972800000",
    "number": "1013919067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 HOSPITAL DRIVE",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "21061",
            "telephone_number": "410-553-8300",
            "fax_number": "410-553-8349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 HOSPITAL DR",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615803",
            "telephone_number": "410-553-8300",
            "fax_number": "410-553-8349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVEAUX",
        "first_name": "THERESA",
        "middle_name": "EILEEN",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-02",
        "last_updated": "2016-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MD",
            "license": "R093166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BLUE CROSS DC",
            "identifier": "F591 0008",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BRAVO/ELDER HEALTH",
            "identifier": "4992",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BLUE CROSS MD",
            "identifier": "61740701",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400067600",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "107423",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "22500900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abaynesh Negash Desalegn, PA-C
• Ann Desjardins-Feldman, LCSW
• Laura Deterding, NP
• Colleen Michele Devaney
• Sudhakar Venkata Lakshmi Devathi, M.D
• Ashley C Devinney
• Manjote Kaur Dhaliwal, D.D.S
• Kuruppunayake S Dharmasena, M.D.
• Maureen Helen Diaczok, R.N.
• Dialog Healthcare LLC

• Acute Care Nurse Practitioner in Glen Burnie, MD
• Providers in Glen Burnie, MD by specialty
• Acute Care Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2016; 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.