Active NPI
Karen Irene Devries
- Physical Therapy Assistant
- Yaphank, NY
National Provider Identifier
1497064836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 001021-1
- Practice address
- 430 Sills Rd
Yaphank, NY 11980 - Phone
- (631) 924-5583
- Fax
- (631) 924-5687
- NPI assigned
- Oct 4, 2010
- Last updated
- Oct 4, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 001021-1 | NY | Primary |
Addresses
Primary practice location
430 Sills Rd
Yaphank, NY 11980
Mailing address
198 Center Garden Blvd
Yaphank, NY 11980-9720
Phone (631) 775-7420
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001021-1 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1286150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1286150400000",
"number": "1497064836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "198 CENTER GARDEN BLVD",
"city": "YAPHANK",
"state": "NY",
"postal_code": "119809720",
"telephone_number": "631-775-7420",
"fax_number": "631-924-5583"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "430 SILLS RD",
"city": "YAPHANK",
"state": "NY",
"postal_code": "11980",
"telephone_number": "631-924-5583",
"fax_number": "631-924-5687"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEVRIES",
"first_name": "KAREN",
"middle_name": "IRENE",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-10-04",
"last_updated": "2010-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NY",
"license": "001021-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Yaphank, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.