Paul Van Deventer MD Apmc

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

License

MD.025612 Issued in LA

Legal business name

PAUL VAN DEVENTER MD APMC

Practice address

1200 Pinnacle Pkwy Ste 3
Covington, LA 70433-9169

Phone

(479) 636-9702

Fax

(877) 427-2307

NPI assigned

Oct 12, 2017

Organization subpart

No

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

Authorized official

Name

Mackenzie Hahn

Title

Ncpdp Coordinator

Phone

(479) 636-9702

Specialties & licenses 1

Addresses

Other names 1

• Pinnacle Orthopaedics Doing business as

Locations

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

{
    "created_epoch": "1507766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510790400000",
    "number": "1104337559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3328",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "72712",
            "telephone_number": "479-636-9702",
            "fax_number": "877-427-2307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 PINNACLE PKWY STE 3",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704339169",
            "telephone_number": "479-636-9702",
            "fax_number": "877-427-2307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL VAN DEVENTER MD APMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-12",
        "last_updated": "2017-11-16",
        "status": "A",
        "authorized_official_last_name": "HAHN",
        "authorized_official_first_name": "MACKENZIE",
        "authorized_official_title_or_position": "NCPDP COORDINATOR",
        "authorized_official_telephone_number": "479-636-9702"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "LA",
            "license": "MD.025612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pinnacle Orthopaedics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Smita S Patel, MD
• Umesh A Patel, MD, FACC
• Patricia Braly MD Apmc
• Paul Craig Parker, MD
• Paul M Doty, MD, Apmc
• Karelle Erica Pearcy, IBCLC
• Tracie Lebleu Pearson, M.D.
• Molly Marie Peck
• Pediatric Therapy and Learning Center of the Northshore
• Marilyn Evelyn Pelias, M.D.

• Non-Pharmacy Dispensing Site in Covington, LA
• Providers in Covington, LA by specialty
• Non-Pharmacy Dispensing Site in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2017; 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.