NPIMap

Organization Active NPI

The Devereux Foundation

  • Community Health Clinic/Center
  • Deland, FL
National Provider Identifier
1265656052
Registry record updated Oct 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
THE DEVEREUX FOUNDATION
Practice address
120 E New York Ave
Deland, FL 32724-5568
Phone
(386) 738-5543
NPI assigned
Apr 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2018

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

Authorized official

Name
Gwendolyn Skinner
Title
Executive Director
Phone
(407) 362-9213

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X Primary

Addresses

Primary practice location

120 E New York Ave
Deland, FL 32724-5568

Mailing address

5850 T G Lee Blvd
Orlando, FL 32822-4407
Phone (407) 362-9213

Other identifiers 1

IdentifierTypeStateIssuer
029573612MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Devereux Florida331 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538611200000",
    "number": "1265656052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5850 T G LEE BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328224407",
            "telephone_number": "407-362-9213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E NEW YORK AVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327245568",
            "telephone_number": "386-738-5543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE DEVEREUX FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2018-10-04",
        "status": "A",
        "authorized_official_last_name": "SKINNER",
        "authorized_official_first_name": "GWENDOLYN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "407-362-9213"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029573612",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Deland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.