Individual provider Active NPI

Devan Haney, PA

  • Physician Assistant
  • Round Mountain, CA
National Provider Identifier
1467270504
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
65115 Issued in CA
Practice address
29632 E Highway 299
Round Mountain, CA 96084-8000
Phone
(530) 337-6243
NPI assigned
Sep 27, 2024
Last updated
Sep 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 65115 CA Primary

Addresses

Primary practice location

29632 E Highway 299
Round Mountain, CA 96084-8000

Mailing address

834 Loma St Unit B
Redding, CA 96003-3612
Phone (262) 573-2951

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241210003456 CA Practitioner - Physician Assistant 2567998867 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
San Juan Bautista School of Medicine, 2024
Medicare assignment
May accept Medicare assignment
Group practices
Hill Country Community ClinicGroup PAC ID 1052442175, 19 clinicians

Practice addresses (Care Compare)

1401 Gold St
Suite a
Redding, CA 96001-1937
Phone (530) 337-5750

29632 E Hwy 299
Round Mountain, CA 96084-8000
Phone (530) 337-5750

3270 Churn Creek Rd
Redding, CA 96002-2504
Phone (530) 337-6243

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - California CurrentSince May 10, 2025 Accepting new patients
Hill Country Community Clinic CurrentSince Oct 28, 2024 Accepting new patients
Cep America-California CurrentSince May 10, 2025 Accepting new patients
Hill Country Community Clinic CurrentSince Oct 28, 2024 Accepting new patients
Hill Country Community Clinic Past Accepting new patients

Locations

726 4th St
Marysville, CA 95901
Phone (530) 491-9491

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

29632 E Highway 299
Round Mtn, CA 96084
Phone (530) 337-5750

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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": "1727395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1467270504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "834 LOMA ST UNIT B",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960033612",
            "telephone_number": "262-573-2951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29632 E HIGHWAY 299",
            "city": "ROUND MOUNTAIN",
            "state": "CA",
            "postal_code": "960848000",
            "telephone_number": "530-337-6243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANEY",
        "first_name": "DEVAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-27",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "65115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Mountain, CA

Sources for this page

Verify at the official NPI Registry.