Devaron Lamar Anderson

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

1502 Mary Kay Blvd
Benton, AR 72015-7201

Phone

(501) 315-3344

Fax

(510) 381-6118

NPI assigned

Apr 7, 2014

Last updated

Mar 18, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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)

Not enrolled

Practice roles

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.

• Bay Area Community Services Inc

  • Community/Behavioral Health Agency
  • Vallejo, CA
  • NPI 1659770873
  NPD (past)

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

{
    "created_epoch": "1396828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584489600000",
    "number": "1528487584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1589",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720181589",
            "telephone_number": "501-315-3344",
            "fax_number": "510-381-6118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 MARY KAY BLVD",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720157201",
            "telephone_number": "501-315-3344",
            "fax_number": "510-381-6118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "DEVARON",
        "middle_name": "LAMAR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-07",
        "last_updated": "2020-03-18",
        "certification_date": "2020-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rodolfo Ambriz, RECOVERY ASSISTANT
• American Heartland Home Medical, Inc.
• American Oncology Partners, P.a. (Genesis Cancer and Blood Institute)
• Amber Anderson, RECOVERY ASSISTANT
• Carolyn Anderson, RECOVERY ASSISTANT
• Jessica Madalyn Anderson, L.C.S.W.
• Julie A. Anderson
• Nikki Leigh Anderson
• Andrews Therapy Group
• Erin Elizabeth Andrews, MS, PT

• Case Manager/Care Coordinator in Benton, AR
• Providers in Benton, AR by specialty
• Case Manager/Care Coordinator in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2020; 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.