Shanta Devaughn

Primary specialty

Home Health AideTaxonomy code 374U00000X

License

79903 Issued in FL

Practice address

846 N Griffith Ave
Crystal River, FL 34429-7669

Phone

(352) 302-6468

NPI assigned

Mar 3, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1740960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740960000000",
    "number": "1114725611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "846 N GRIFFITH AVE",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "344297669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "846 N GRIFFITH AVE",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "344297669",
            "telephone_number": "352-302-6468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVAUGHN",
        "first_name": "SHANTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-03",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "FL",
            "license": "79903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debbies Kids,Inc
• John R Degraw, M.D.
• Jeffrey Eugene Depaul, PH.D., LMHC
• Desaraju & Kompella, P.a.
• Chakradhar Desaraju, MD
• DH Pritchard MD PA
• Alex Jonathan Dickert, M.D.
• Amanda Carroll Dickert, ARNP
• Jim C Dickert, DO
• Kaitlyn Dickert, PA-C

• Home Health Aide in Crystal River, FL
• Providers in Crystal River, FL by specialty
• Home Health Aide in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2025; 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.