NPIMap

Individual provider Active NPI

Devon K Somerville, PA-C

  • Medical Physician Assistant
  • Franklin, WV
National Provider Identifier
1609184688
Registry record updated Dec 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
01507 Issued in WV
Practice address
82 Pine St
Franklin, WV 26807-0100
Phone
(304) 358-2355
Fax
(304) 358-3054
NPI assigned
Sep 23, 2010
Last updated
Dec 12, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 01507 WV Primary

Addresses

Primary practice location

82 Pine St
Franklin, WV 26807-0100

Mailing address

PO Box 100
Franklin, WV 26807-0100
Phone (304) 358-2355

Other identifiers 1

IdentifierTypeStateIssuer
3810021451MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110506000504 WV Practitioner - Physician Assistant 4880879840 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
May accept Medicare assignment
Group practices
Pendleton Community Care IncGroup PAC ID 3678470614, 11 clinicians

Practice addresses (Care Compare)

PO Box
Suite 100
Franklin, WV 26807

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
01507WVMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pendleton Community Care, Inc. CurrentSince Mar 18, 2011 Accepting new patients
Pendleton Community Care Inc Past Accepting new patients
Pendleton Community Care Inc Past Accepting new patients
Pendleton Community Care, Inc. Past Accepting new patients
Pendleton Community Care Inc Past Accepting new patients
Pendleton Community Care, Inc. Past Accepting new patients
Pendleton Community Care Inc Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Pendleton Community Care Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: devon.somerville.1@6719.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/6719/brand/1/csg/1/fhir/r4

Organizations & group practices 10

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1285200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481500800000",
    "number": "1609184688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100",
            "city": "FRANKLIN",
            "state": "WV",
            "postal_code": "268070100",
            "telephone_number": "304-358-2355",
            "fax_number": "304-358-3054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 PINE ST",
            "city": "FRANKLIN",
            "state": "WV",
            "postal_code": "268070100",
            "telephone_number": "304-358-2355",
            "fax_number": "304-358-3054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOMERVILLE",
        "first_name": "DEVON",
        "middle_name": "K",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-23",
        "last_updated": "2016-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WV",
            "license": "01507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810021451",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin, WV

Sources for this page

Verify at the official NPI Registry.