Jennifer Deverin

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA77506 Issued in FL

Practice address

304 Kingsley Lake Dr Ste 603
Saint Augustine, FL 32092-3042

Phone

(904) 447-6550

NPI assigned

Feb 5, 2024

Last updated

Feb 23, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1707091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708646400000",
    "number": "1063275824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6327 BAYFIELD DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322772530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 KINGSLEY LAKE DR STE 603",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320923042",
            "telephone_number": "904-447-6550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVERIN",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-05",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA77506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rodnika Desmore
• Godlive Desravines, APRN
• Jacob Matheny Desuyo, DSL, BCBA
• Tara Lovett Dettra, L.M., C.P.M.
• Michael David Deveau, MD
• Valerie Catherine Deville, LMHC
• John Devlin
• Laurie A Dewitt, C.R.N.A.
• Vijayselwyn Davis Dhas, M.D.
• Natalie Ann Di Angelo, MA,CCC-SLP

• Massage Therapist in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Massage Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2024; 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.