Active NPI
John Devine
- Community Health Worker
- Upland, CA
National Provider Identifier
1467863175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 1126 W Foothill Blvd
Ste. 150
Upland, CA 91786-3768 - Phone
- (909) 982-8641
- Fax
- (909) 982-8642
- NPI assigned
- May 15, 2014
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | Primary |
Addresses
Primary practice location
1126 W Foothill Blvd
Ste. 150
Upland, CA 91786-3768
Mailing address
1126 W Foothill Blvd
Ste. 150
Upland, CA 91786-3768
Phone (909) 982-8641
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)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Reach Out West End | Past | Accepting new patients |
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.
-
- Community/Behavioral Health Agency
- Jurupa Valley, CA
- NPI 1215256300
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1400112000000",
"number": "1467863175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1126 W FOOTHILL BLVD",
"address_2": "STE. 150",
"city": "UPLAND",
"state": "CA",
"postal_code": "917863768",
"telephone_number": "909-982-8641",
"fax_number": "909-982-8642"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1126 W FOOTHILL BLVD",
"address_2": "STE. 150",
"city": "UPLAND",
"state": "CA",
"postal_code": "917863768",
"telephone_number": "909-982-8641",
"fax_number": "909-982-8642"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEVINE",
"first_name": "JOHN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-05-15",
"last_updated": "2014-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Upland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.