Shana Leah Deveaux

Individual provider Active NPI Nurse Practitioner · Clinton, MA

NPI 1154082204 · NPPES record last updated Aug 4, 2023

Key facts

NPI
1154082204
Entity type
Individual (NPI type 1)
Primary specialty
Nurse Practitioner 363L00000X
License
RN2348440 (MA)
Practice address
236 Main St
Clinton, MA 01510-4022
Phone
(518) 322-6095
NPI assigned
Dec 31, 2021
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

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 fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN2348440MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC Nurse Practitioner Current
since Jun 10, 2024
Accepting new patients
Ipc Hospitalists of New England, P.C. Nurse Practitioner Past Accepting new patients

Locations

155 Federal St
Ste 700
Boston, MA 02110
Phone (469) 466-7420

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JGJAED/Endpoint/JGJAED

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN2348440 MA
Nurse Practitioner 363L00000X RN2348440 MA Yes

Addresses

Primary practice location

236 Main St
Clinton, MA 01510-4022

Mailing address

236 Main St
Clinton, MA 01510-4022
Phone (518) 322-6095

Other names

  • Shana Leah Orourke Former name

Other providers in Clinton, MA

All providers in Clinton, MA · Nurse Practitioner in Massachusetts

Sources for this page

Verify at the official NPI Registry.