Individual provider Active NPI

Robert Dean Devlin II

  • Family Nurse Practitioner
  • Dallas, GA
National Provider Identifier
1093471153
Registry record updated Nov 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN248400 Issued in GA
Practice address
302 Paulding Blvd
Dallas, GA 30157-0635
Phone
(229) 269-7889
NPI assigned
Nov 12, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN248400 GA Primary

Addresses

Primary practice location

302 Paulding Blvd
Dallas, GA 30157-0635

Mailing address

302 Paulding Blvd
Dallas, GA 30157-0635
Phone (229) 269-7889

Other identifiers 1

IdentifierTypeStateIssuer
RN248400OtherGAGEORGIA BOARD OF NURSING

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220420002436 GA Practitioner - Nurse Practitioner 3971990045 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Bortolazzo Group, LLC CurrentSince Mar 20, 2022 Accepting new patients

Locations

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

8954 Hospital Dr
Douglasville, GA 30134
Phone (678) 838-2584

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1636675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1093471153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 PAULDING BLVD",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301570635",
            "telephone_number": "229-269-7889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 PAULDING BLVD",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301570635",
            "telephone_number": "229-269-7889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVLIN",
        "first_name": "ROBERT",
        "middle_name": "DEAN",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-12",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN248400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA BOARD OF NURSING",
            "identifier": "RN248400",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, GA

Sources for this page

Verify at the official NPI Registry.