NPIMap

Organization Active NPI

Devereux

  • Community Health Clinic/Center
  • Orlando, FL
National Provider Identifier
1326301706
Registry record updated Jun 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
License
160994624 Issued in FL
Legal business name
DEVEREUX
Practice address
5850 T G Lee Blvd
Suite 400
Orlando, FL 32822-4407
Phone
(321) 281-3840
NPI assigned
Jun 20, 2012
Last updated
Jun 20, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2012

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

Authorized official

Name
Jacquita ElstonNPI 1700123270
Title
Therapist
Phone
(321) 281-3840

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X 160994624 FL Primary

Addresses

Primary practice location

5850 T G Lee Blvd
Suite 400
Orlando, FL 32822-4407

Mailing address

1010 Executive Center Dr
Suite 100
Orlando, FL 32803-3529

Other identifiers 1

IdentifierTypeStateIssuer
029573621MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Devereux Arizona332 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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1340150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340150400000",
    "number": "1326301706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 EXECUTIVE CENTER DR",
            "address_2": "SUITE 100",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328033529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5850 T G LEE BLVD",
            "address_2": "SUITE 400",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328224407",
            "telephone_number": "321-281-3840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVEREUX",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-20",
        "last_updated": "2012-06-20",
        "status": "A",
        "authorized_official_last_name": "ELSTON",
        "authorized_official_first_name": "JACQUITA",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "321-281-3840"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "FL",
            "license": "160994624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029573621",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2012; 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.