NPIMap

Organization Active NPI

Devereux Foundation, Inc.

  • Foster Care Agency
  • Bartow, FL
National Provider Identifier
1053470385
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foster Care AgencyTaxonomy code 253J00000X
Legal business name
DEVEREUX FOUNDATION, INC.
Practice address
3350 State Road 60 E
Bartow, FL 33830-8471
Phone
(813) 460-4451
NPI assigned
Dec 6, 2006
Last updated
Nov 6, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Authorized official

Name
Jessica Lyles
Title
National Director of Accounts Recei
Phone
(267) 637-4536

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foster Care Agency 253J00000X Primary

Addresses

Primary practice location

3350 State Road 60 E
Bartow, FL 33830-8471

Mailing address

5850 T.G. Lee Blvd
Suite 400
Orlando, FL 32822
Phone (407) 362-9210

Other identifiers 1

IdentifierTypeStateIssuer
029573603MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Devereux Arizona332 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

3350 State Road 60 E
Bartow, FL 33830
Phone (813) 460-4451

203 Avenue A NW
Winter Haven, FL 33881
Phone (863) 299-7787

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699228800000",
    "number": "1053470385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5850 T.G. LEE BLVD",
            "address_2": "SUITE 400",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32822",
            "telephone_number": "407-362-9210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 STATE ROAD 60 E",
            "city": "BARTOW",
            "state": "FL",
            "postal_code": "338308471",
            "telephone_number": "813-460-4451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVEREUX FOUNDATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A",
        "authorized_official_last_name": "LYLES",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "NATIONAL DIRECTOR OF ACCOUNTS RECEI",
        "authorized_official_telephone_number": "267-637-4536"
    },
    "taxonomies": [
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029573603",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bartow, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; 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.