NPIMap

Organization Active NPI

Devlin & Huberty PS

  • Obstetrics & Gynecology Physician
  • Pullman, WA
National Provider Identifier
1063582971
Registry record updated Jan 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
600100244 Issued in WA
Legal business name
DEVLIN & HUBERTY PS
Practice address
1205 SE Professional Mall Blvd
Ste 102
Pullman, WA 99163-5423
Phone
(509) 332-7511
Fax
(509) 334-4712
NPI assigned
Nov 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2012

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

Authorized official

Name
Dr. Ric MinudriNPI 1972567857
Title
Officer
Phone
(509) 332-7511

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X 600100244 WA Primary

Addresses

Primary practice location

1205 SE Professional Mall Blvd
Ste 102
Pullman, WA 99163-5423

Mailing address

1205 SE Professional Mall Blvd
Ste 102
Pullman, WA 99163-5423
Phone (509) 332-7511

Other names 1

  • Moscow Pullman OB GYN Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040308001367 WA Part B Supplier - Clinic/Group Practice 2668360934 Receives reassigned benefits from 5 practitioners
Practice locations: Pullman, WA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Devlin Huberty PS2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1150 Alturas Dr
Ste 101
Moscow, ID 83843
Phone (208) 310-7773

1205 SE Professional Mall Blvd
Ste 102
Pullman, WA 99163
Phone (509) 332-7511

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325635200000",
    "number": "1063582971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 SE PROFESSIONAL MALL BLVD",
            "address_2": "STE 102",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635423",
            "telephone_number": "509-332-7511",
            "fax_number": "509-334-4712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 SE PROFESSIONAL MALL BLVD",
            "address_2": "STE 102",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635423",
            "telephone_number": "509-332-7511",
            "fax_number": "509-334-4712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVLIN & HUBERTY PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2012-01-04",
        "status": "A",
        "authorized_official_last_name": "MINUDRI",
        "authorized_official_first_name": "RIC",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "509-332-7511",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "WA",
            "license": "600100244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Moscow Pullman OB GYN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pullman, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.