Active NPI
William G. Devanney, C.PH.
- Pharmacist
- Indialantic, FL
National Provider Identifier
1083918908
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS21628
- 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, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| PS21628 | FL | MD | Pharmacist |
| PU5613 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Publix Super Markets, Inc. | Current | Accepting new patients | |
| Publix Super Markets Inc | Past | 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.
-
dba Publix Pharmacy #1688
- Community/Retail Pharmacy
- Indialantic, FL
- NPI 1891330940
-
dba Publix Pharmacy #2107
- Community/Retail Pharmacy
- Winter Haven, FL
- NPI 1760356380
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.