Patricia Devisser, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601004735 Issued in MI

Practice address

1900 Wealthy St SE
Suite 200
Grand Rapids, MI 49506-2969

Phone

(616) 974-4668

NPI assigned

May 18, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Michigan Medical Patient Care

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1073567806
  NPD (past)
• Michigan Medical Patient Care

  • Durable Medical Equipment & Medical Supplies
  • Holland, MI
  • NPI 1871741652
  NPD (past)

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218067200000",
    "number": "1497708853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4085 BURTON ST SE",
            "address_2": "SUITE 200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 WEALTHY ST SE",
            "address_2": "SUITE 200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495062969",
            "telephone_number": "616-974-4668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVISSER",
        "first_name": "PATRICIA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-18",
        "last_updated": "2008-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601004735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clare Susan Deveau, LMSW
• John P Deveau, DO
• Rajeev Deveshwar, M.D.
• Devi Fongers
• Ryan Devies
• Kimberly Sue Devlin, D.O.
• Deborah L Devoe, PT
• Andrew Bennett Devoest
• Joane Devon, LBSW
• Ashley K Devos, L.L.M.S.W.

• Physician Assistant in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2008; 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.