Gary Devoss, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

21978 Issued in IA

Practice address

1001 Risen Son Blvd
Council Bluffs, IA 51503-1910

Phone

(712) 256-8600

Fax

(712) 256-8599

NPI assigned

Aug 19, 2006

Last updated

Dec 17, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387238400000",
    "number": "1467566836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3755",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681030755",
            "telephone_number": "402-354-2100",
            "fax_number": "402-354-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 RISEN SON BLVD",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515031910",
            "telephone_number": "712-256-8600",
            "fax_number": "712-256-8599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVOSS",
        "first_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2013-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NE",
            "license": "16280",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "21978",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47068731712",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1467566836",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47068731263",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly M Deroos, LMHC
• Anand Deshmukh, MD
• Kaitlin Nicole Desoe, APRN
• Developmental Disability Center of Iowa LLC (Ddci)
• Patsy Devereaux
• Diagnostic & Int Med Assoc PC
• James Davin Dickerson, ARNP
• Mark Dickey
• Avery Justine Dickinson, PT, DPT
• Mindy Jane Dickinson, O.D.

• Internal Medicine Physician in Council Bluffs, IA
• Providers in Council Bluffs, IA by specialty
• Internal Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 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.

Verify at the official NPI Registry.