Individual provider Active NPI

William G. Devanney, C.PH.

  • Pharmacist
  • Indialantic, FL
National Provider Identifier
1083918908
Registry record updated Jul 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS21628 Issued in FL
Practice address
700 North Miramar Ave
Indialantic, FL 32903
Phone
(321) 339-5012
Fax
(321) 312-3978
NPI assigned
Jan 6, 2011
Last updated
Jul 14, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PU5613 FL
Pharmacist 183500000X PS21628 FL Primary

Addresses

Primary practice location

700 North Miramar Ave
Indialantic, FL 32903

Mailing address

700 N Miramar Ave
Indailantic, FL 32903
Phone (321) 339-5012

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

State licenses

LicenseStateTypeSpecialty
PS21628FLMDPharmacist
PU5613FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Publix Super Markets, Inc. CurrentSince Jun 14, 2020 Accepting new patients
Publix Super Markets Inc PastSince Jun 14, 2020 Accepting new patients

Locations

700 N Miramar Ave
Indialantic, FL 32903
Phone (321) 339-5012

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1294272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594684800000",
    "number": "1083918908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 N MIRAMAR AVE",
            "city": "INDAILANTIC",
            "state": "FL",
            "postal_code": "32903",
            "telephone_number": "321-339-5012",
            "fax_number": "321-312-3978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 NORTH MIRAMAR AVE",
            "city": "INDIALANTIC",
            "state": "FL",
            "postal_code": "32903",
            "telephone_number": "321-339-5012",
            "fax_number": "321-312-3978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVANNEY",
        "first_name": "WILLIAM",
        "middle_name": "G.",
        "credential": "C.PH.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-06",
        "last_updated": "2020-07-14",
        "certification_date": "2020-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PU5613",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS21628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indialantic, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2020; 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.