Active NPI
James Russell Devillier, MD
- Clinical Pathology/Laboratory Medicine Physician
- Roxboro, NC
National Provider Identifier
1457403206
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Pathology/Laboratory Medicine Physician
- License
- 9500554
- Practice address
- 296 Denada Path
Roxboro, NC 27574-6306 - Phone
- (336) 659-9440
- Fax
- (336) 659-9845
- NPI assigned
- Jan 18, 2007
- Last updated
- Jun 12, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Pathology/Laboratory Medicine Physician | 207ZP0105X | 9500554 | NC | Primary |
Addresses
Primary practice location
296 Denada Path
Roxboro, NC 27574-6306
Mailing address
296 Denada Path
Roxboro, NC 27574-6306
Phone (336) 659-9440
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5900890 | Medicaid | NC | |
| 140WF | Other | NC | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9500554 | NC | MD | Clinical Pathology/Laboratory Medicine Physician |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Specialist
- Roxboro, NC
- NPI 1992975460
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1370995200000",
"number": "1457403206",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "296 DENADA PATH",
"city": "ROXBORO",
"state": "NC",
"postal_code": "275746306",
"telephone_number": "336-659-9440",
"fax_number": "336-659-9845"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "296 DENADA PATH",
"city": "ROXBORO",
"state": "NC",
"postal_code": "275746306",
"telephone_number": "336-659-9440",
"fax_number": "336-659-9845"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEVILLIER",
"first_name": "JAMES",
"middle_name": "RUSSELL",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-18",
"last_updated": "2013-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0105X",
"taxonomy_group": "",
"desc": "Pathology, Clinical Pathology/Laboratory Medicine",
"state": "NC",
"license": "9500554",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5900890",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "140WF",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Roxboro, NC
- Jean Ann Davison
- Thomas Jones Day Jr., DDS
- Daymark Recovery Services Inc
- Jay Emmanuel De la Cruz
- Melissa Roseann Dean-Appasu, NP
- Vijay R Dhoopati, MD
- Lauren Dipietro, OTR/L
- DLP Person Memorial Hospital LLC (Person Memorial Hospital)
- DLP Person Memorial Hospital LLC (Person Memorial Hospital)
- DLP Person Memorial Hospital LLC (Person Memorial Hospital)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.