Blood and Cancer Clinic, PA

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

Legal business name

BLOOD AND CANCER CLINIC, PA

Practice address

2125 Valleygate Dr
Suite 101
Fayetteville, NC 28304-3657

Phone

(910) 483-8586

Fax

(910) 483-9212

NPI assigned

Apr 13, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Shirish D Devasthali, MDNPI 1851454995

Title

President

Phone

(910) 483-8586

Specialties & licenses 1

Addresses

Other identifiers 4

Tax ID family

All American Rehabilitation Solutions2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• All American Rehabilitation Solutions

  • Physical Therapist
  • Fayetteville, NC
  • NPI 1467455899
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shirish D Devasthali, M.D.

  • Hematology & Oncology Physician
  • Fayetteville, NC
  • NPI 1851454995
  NPD (past) Authorized official

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174747711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 53095",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283053095",
            "telephone_number": "910-483-8586",
            "fax_number": "910-483-9212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2125 VALLEYGATE DR",
            "address_2": "SUITE 101",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043657",
            "telephone_number": "910-483-8586",
            "fax_number": "910-483-9212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOD AND CANCER CLINIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DEVASTHALI",
        "authorized_official_first_name": "SHIRISH",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-483-8586",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY",
            "identifier": "02701",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP NUMBER",
            "identifier": "3400936",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY",
            "identifier": "02699",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "38929",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Audrey Blevins
• Evette Lemille Blevins
• Monica Block, OTR/L
• Kyle Paul Blomgren, DO
• Blood & Cancer Clinic, P.a.
• Bloom in Journey PLLC
• Crystal Lynn Bloomer, LPN
• Bridget Blount
• Andrea Blue, RBT
• Carolyn Blue

• Non-Pharmacy Dispensing Site in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Non-Pharmacy Dispensing Site in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.