Active NPI
William Conrad Devereux, PHD, JD
- Clinical Psychologist
- Durham, NC
National Provider Identifier
1528091493
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 4704
- Practice address
- 2511 Old Cornwallis Rd
Suite 200
Durham, NC 27713-1869 - Phone
- (919) 932-5700
- Fax
- (919) 933-6881
- NPI assigned
- Jul 7, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 4704 | NC | Primary |
Addresses
Primary practice location
2511 Old Cornwallis Rd
Suite 200
Durham, NC 27713-1869
Mailing address
2511 Old Cornwallis Rd
Suite 200
Durham, NC 27713-1869
Phone (919) 932-5700
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)
- Enrolled
- Credentials
- Juris Doctor, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704 | NC | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| James November PHD PA | Clinical | 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 and National Provider Directory roles.
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- Clinical Psychologist
- Jacksonville, FL
- NPI 1104193119
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469491200000",
"number": "1528091493",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2511 OLD CORNWALLIS RD",
"address_2": "SUITE 200",
"city": "DURHAM",
"state": "NC",
"postal_code": "277131869",
"telephone_number": "919-932-5700",
"fax_number": "919-933-6881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2511 OLD CORNWALLIS RD",
"address_2": "SUITE 200",
"city": "DURHAM",
"state": "NC",
"postal_code": "277131869",
"telephone_number": "919-932-5700",
"fax_number": "919-933-6881"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEVEREUX",
"first_name": "WILLIAM",
"middle_name": "CONRAD",
"name_prefix": "Dr.",
"credential": "PHD, JD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-07",
"last_updated": "2016-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NC",
"license": "4704",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.