Individual provider Active NPI

Brett Jordan Devoursney, DO

  • Family Medicine Physician
  • Orlando, FL
National Provider Identifier
1336713171
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS19572 Issued in FL
Practice address
2863 Delaney Ave
Orlando, FL 32806-5495
Phone
(407) 843-1620
NPI assigned
May 17, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X OS19572 FL Primary

Addresses

Primary practice location

2863 Delaney Ave
Orlando, FL 32806-5495

Mailing address

3334 Burgandy Branch Dr
Orange Park, FL 32065-6686
Phone (904) 412-1368

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240711001534 FL Practitioner - Family Practice 3072914530 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Edward Via Col of Osteo Medicine-Carolinas Campus, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Janovitz Parrillo Delgado and Shah MD PAGroup PAC ID 1456357664, 12 clinicians

Practice addresses (Care Compare)

2863 Delaney Ave
Orlando, FL 32806-5412
Phone (407) 843-1620

Hospital & facility affiliations

  • Orlando Health Hospital, Orlando, FL, CCN 100006
  • Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Janovitz Parrillo Delgado & Shah MD PA Family Medicine CurrentSince Jul 31, 2024 Accepting new patients

Locations

2863 Delaney Ave
Orlando, FL 32806
Phone (407) 720-4034

2859 Delaney Ave
Orlando, FL 32806
Phone (407) 843-1620

Interoperability endpoints

  • Direct secure messaging: bdevoursney127508@adventhealth.direct-ci.com

Organizations & group practices 1

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1621209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1336713171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3334 BURGANDY BRANCH DR",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320656686",
            "telephone_number": "904-412-1368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2863 DELANEY AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328065495",
            "telephone_number": "407-843-1620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVOURSNEY",
        "first_name": "BRETT",
        "middle_name": "JORDAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-17",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS19572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.