Charles Joseph Devine III, MD

Primary specialty

Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X

License

0101034518 Issued in VA

Practice address

434 Washington St.
Boydton, VA 23917

Phone

(434) 738-6815

Fax

(434) 738-6295

NPI assigned

Feb 15, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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

• Commonwealth of Virginia State Board of Health

  dba Nelson County Health Department

  • Public Health or Welfare Agency
  • Arrington, VA
  • NPI 1679580922
  NPD (past)

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053454058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "434 WASHINGTON ST.",
            "address_2": "PO BOX 560",
            "city": "BOYDTON",
            "state": "VA",
            "postal_code": "23917",
            "telephone_number": "434-738-6815",
            "fax_number": "434-738-6295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "434 WASHINGTON ST.",
            "city": "BOYDTON",
            "state": "VA",
            "postal_code": "23917",
            "telephone_number": "434-738-6815",
            "fax_number": "434-738-6295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVINE",
        "first_name": "CHARLES",
        "middle_name": "JOSEPH",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "VA",
            "license": "0101034518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5811007",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Joseph Coleman, PHARMD, MBA
• Commonwealth of Virginia State Board of Health (Mecklenburg County Health Department)
• Lina Sue Crowder, M.D.
• Amanda Davis, M.S., CCC-SLP
• Samantha Lynn Dean, MSSW, LCSW
• DMV Family Care Services
• David William Eason, DDS
• Efficient Transportation Services
• Marie Goodwin, MSN FNP-C
• Carolyn Shores Hoyle, APRN/ FNP-C

• Public Health & General Preventive Medicine Physician in Boydton, VA
• Providers in Boydton, VA by specialty
• Public Health & General Preventive Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.