Vernon T Devine, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP0131 Issued in MN

Practice address

4500 Park Glen Rd
Suite 360
St Louis Park, MN 55416-4871

Phone

(952) 929-9478

Fax

(952) 929-9548

NPI assigned

Sep 28, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Jacquelyn K. Wiersma, PH. D., LP, PLLC

  • Clinical Psychologist
  • Minnetonka, MN
  • NPI 1770696726
  NPD (past)
• Nancy Hawkins & Associates

  • Clinical Psychologist
  • St Louis Park, MN
  • NPI 1831339290
  NPD (past)

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457443582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 PARK GLEN RD",
            "address_2": "SUITE 360",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554164871",
            "telephone_number": "952-929-9478",
            "fax_number": "952-929-9548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 PARK GLEN RD",
            "address_2": "SUITE 360",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554164871",
            "telephone_number": "952-929-9478",
            "fax_number": "952-929-9548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVINE",
        "first_name": "VERNON",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP0131",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181547400",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSMN",
            "identifier": "1F223DE",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH",
            "identifier": "61-20116",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Luke Desilet, DO
• Jordan Rae Dettmann
• Jennifer A Deutz, P.T.
• Developing Minds Psychology, PLLC
• Jane Catalina Dever, M.D.
• Alexander Dewar, PA-C
• Alan H. Diamond, O.D.
• Mackenzie Rose Diaz
• Lauren Marie Dick, AGNP
• J Timothy Diegel

• Clinical Psychologist in St Louis Park, MN
• Providers in St Louis Park, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.