Devine Healthcare LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

DEVINE HEALTHCARE LLC

Practice address

956 Molloy Dr
O Fallon, MO 63366-3229

Phone

(314) 496-1858

NPI assigned

Sep 5, 2012

Last updated

Aug 18, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Teconda L. Douglas, ANP-BC

Title

Adult Nurse Practitioner, Owner

Phone

(314) 496-1858

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1346803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408320000000",
    "number": "1538418561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "956 MOLLOY DR",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633663229",
            "telephone_number": "314-496-1858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "956 MOLLOY DR",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633663229",
            "telephone_number": "314-496-1858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVINE HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-05",
        "last_updated": "2014-08-18",
        "status": "A",
        "authorized_official_last_name": "DOUGLAS",
        "authorized_official_first_name": "TECONDA",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "ADULT NURSE PRACTITIONER, OWNER",
        "authorized_official_telephone_number": "314-496-1858",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "ANP-BC"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2014; 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.