Individual provider Active NPI

Mary Lou Devaul - Eshleman, D.O.

  • Psychiatry Physician
  • St Marys, GA
National Provider Identifier
1104972025
Registry record updated Mar 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
68402 Issued in GA
Practice address
605 Osborne St
St Marys, GA 31558-1331
Phone
(919) 946-2702
NPI assigned
Jan 25, 2007
Sex
Female
Sole proprietor
Yes

Organizations & group practices 12

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.

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130723000088 GA Practitioner - Psychiatry 9234210964 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Department of Behavioral Health and Developmental Disabilities CurrentSince Jun 2, 2013 Accepting new patients
Faith Psychiatry LLC Current Accepting new patients
Pocahontas Memorial Hospital CurrentSince Aug 19, 2022 Accepting new patients
Department of Behavioral Health & Developmental Disabilities, Ga CurrentSince Jun 2, 2013 Accepting new patients
Department of Behavioral Health and Developmental Disabilities Current Accepting new patients
Community Service Board of Middle Georgia CurrentSince Sep 16, 2014 Accepting new patients
Pathways Center for Behavioral and Developmental Growth Past Accepting new patients
Pathways Center for Behavioral & Developmental Growth PastSince Nov 24, 2019 Accepting new patients
David J. Humphreys, MD, Psychiatrist Inc. Psychiatry Past Accepting new patients
Pathways Center for Behavioral and Developmental Growth Past Accepting new patients
Evergreen Behavioral Management Inc Past Accepting new patients

Locations

3405 Old Savannah Rd
Augusta, GA 30906
Phone (705) 790-2030

2121A Bellevue Rd
Dublin, GA 31021
Phone (478) 272-1190

223 N Anderson Dr
Swainsboro, GA 30401
Phone (478) 289-2522

57 Duncan Rd
Buckeye, WV 24924
Phone (304) 799-1075

150 Duncan Rd
Buckeye, WV 24924
Phone (304) 799-7400

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 68402 GA Primary

Addresses

NPPES NPI Registry

Primary practice location

605 Osborne St
St Marys, GA 31558-1331

Mailing address

605 Osborne St
Saint Marys, GA 31558-8410
Phone (919) 946-2702

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 26, 2014.

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395792000000",
    "number": "1104972025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 OSBORNE ST",
            "city": "SAINT MARYS",
            "state": "GA",
            "postal_code": "315588410",
            "telephone_number": "919-946-2702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 OSBORNE ST",
            "city": "ST MARYS",
            "state": "GA",
            "postal_code": "315581331",
            "telephone_number": "919-946-2702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVAUL - ESHLEMAN",
        "first_name": "MARY",
        "middle_name": "LOU",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2014-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "68402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Marys, GA

Sources for this page

Verify at the official NPI Registry.