Individual provider Active NPI

Roxanne S. Devane, RN, FNP

  • Nurse Practitioner
  • Wilmington, NC
National Provider Identifier
1053309989
Registry record updated Jun 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
201527 Issued in NC
Practice address
3311 Burnt Mill Dr
Wilmington, NC 28403-2654
Phone
(910) 251-5817
Fax
(910) 251-2652
NPI assigned
Oct 13, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 201527 NC Primary

Addresses

Primary practice location

3311 Burnt Mill Dr
Wilmington, NC 28403-2654

Mailing address

3311 Burnt Mill Dr
Wilmington, NC 28403-2654
Phone (910) 251-5817

Other identifiers 1

IdentifierTypeStateIssuer
201527OtherNCLICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
201527NCMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370217600000",
    "number": "1053309989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3311 BURNT MILL DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284032654",
            "telephone_number": "910-251-5817",
            "fax_number": "910-251-2652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3311 BURNT MILL DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284032654",
            "telephone_number": "910-251-5817",
            "fax_number": "910-251-2652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVANE",
        "first_name": "ROXANNE",
        "middle_name": "S.",
        "name_prefix": "Mrs.",
        "credential": "RN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-13",
        "last_updated": "2013-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "201527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "201527",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2013; 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.