Devon Adair Bathurst, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110001432 Issued in VA

Practice address

Brandon Regional Hospital
119 Oakfield Dr.
Brandon, FL 33511

Phone

(813) 681-5551

Fax

(757) 686-0541

NPI assigned

Aug 24, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Devon Adair Coellner Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Laser Spine Institute, LLC

  • Specialist
  • Tampa, FL
  • NPI 1265483895
  NPD (past)
• Rainier Emergency Physicians LLC

  • Emergency Medicine Physician
  • Plant City, FL
  • NPI 1508275447

  Physician Assistant

  NPD (past)
• Southern Surgical Associates PLLC

  • Surgery Physician
  • Virginia Beach, VA
  • NPI 1154368975
  NPD (past)
• Virginia Beach Surgery, LTD

  • Surgery Physician
  • Virginia Beach, VA
  • NPI 1558614958
  NPD (past)

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1104933241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 OAKFIELD DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115779",
            "telephone_number": "813-681-5551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BRANDON REGIONAL HOSPITAL",
            "address_2": "119 OAKFIELD DR.",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "33511",
            "telephone_number": "813-681-5551",
            "fax_number": "757-686-0541"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Laser Spine Institute",
            "address_2": "5332 Avion Park Dr.",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "33607",
            "country_code": "US",
            "telephone_number": "813-392-7609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BATHURST",
        "first_name": "DEVON",
        "middle_name": "ADAIR",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110001432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEVON",
            "last_name": "COELLNER",
            "middle_name": "ADAIR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Bashar Al Khouri,PA
• Allison Baska
• Andrea Esinhart Baskey, M.S., CCC-SLP
• Keith Joseph Basler
• Ameer Basta, MD
• Liudmila Batista Fandino
• Dana Ann Battaglia
• Kelly Batten
• Steven J. Bauer, M.D.
• Howard W Baum III

• Physician Assistant in Brandon, FL
• Providers in Brandon, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.