Nicole A Devries, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

303194-031 Issued in WI

Practice address

206 Mary St
Beaver Dam, WI 53916-1510

Phone

(920) 296-6877

NPI assigned

Feb 24, 2009

Last updated

Feb 24, 2009By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

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

{
    "created_epoch": "1235433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235433600000",
    "number": "1346480803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 MARY ST",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539161510",
            "telephone_number": "920-296-6877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 MARY ST",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539161510",
            "telephone_number": "920-296-6877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVRIES",
        "first_name": "NICOLE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-24",
        "last_updated": "2009-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "303194-031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Erin Dennison, D.P.T
• Kyle M Dennison, DPM
• Dentistry With Dr M LLC (Beaver Dam Family Dentistry)
• Maria Derksen
• Lisa Lee Derr, LPC-IT
• Dodge County Chiropractic Service Corporation (Chiropractic USA)
• Dr S Zec SC
• Dr. Mary Grote
• Michael Dull II, PHARMD
• Brian J Dvorak, PT

• Licensed Practical Nurse in Beaver Dam, WI
• Providers in Beaver Dam, WI by specialty
• Licensed Practical Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.