Active NPI
Samuel Douglas Devine, RPH
- Pharmacist
- Des Moines, IA
National Provider Identifier
1487760336
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 15182
- Practice address
- VA Hospital (119)
3600 30TH St
Des Moines, IA 50310 - Phone
- (515) 699-5657
- NPI assigned
- Aug 22, 2006
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 15182 | IA | Primary |
Addresses
Primary practice location
VA Hospital (119)
3600 30TH St
Des Moines, IA 50310
Mailing address
2287 Adams St
Cumming, IA 50061-5603
Phone (515) 699-5657
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15182 | IA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1487760336",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2287 ADAMS ST",
"city": "CUMMING",
"state": "IA",
"postal_code": "500615603",
"telephone_number": "515-699-5657"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "VA HOSPITAL (119)",
"address_2": "3600 30TH ST",
"city": "DES MOINES",
"state": "IA",
"postal_code": "50310",
"telephone_number": "515-699-5657"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEVINE",
"first_name": "SAMUEL",
"middle_name": "DOUGLAS",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IA",
"license": "15182",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Des Moines, IA
Sources for this page
- 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.