Individual provider Active NPI

Tammy S Devereux, APRN

  • Adult Health Nurse Practitioner
  • Rutland, VT
National Provider Identifier
1609587492
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
101.0135875 Issued in VT
Practice address
79 Center St Ste 1-1
Rutland, VT 05701-4061
Phone
(802) 772-7107
Fax
(802) 772-9003
NPI assigned
Dec 12, 2022
Last updated
Feb 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 101.0135875 VT Primary

Addresses

Primary practice location

79 Center St Ste 1-1
Rutland, VT 05701-4061

Mailing address

30 Grape St
Fair Haven, VT 05743-1049
Phone (802) 772-7107

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230411000785 VT Practitioner - Nurse Practitioner 9234504986 Reassigns benefits to 2 organizations
I20240705001352 NY Practitioner - Nurse Practitioner 9234504986 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

79 Ctr St
Suite 1 1
Rutland, VT 05701-4061
Phone (802) 772-7107

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
101.0135875VTMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Taconic Essential Primary Care Adult Health CurrentSince Feb 1, 2025 Accepting new patients
True Care Vermont, LLC CurrentSince Mar 6, 2023 Accepting new patients
Aim Healthcare Providers VT, LLC CurrentSince Oct 9, 2024 Accepting new patients
Medical Director Services PC CurrentSince May 1, 2024 Accepting new patients

Locations

161 E Rivulon Blvd
Ste 210
Gilbert, AZ 85297
Phone (480) 244-1724

50 Sheffield Ave
Brooklyn, NY 11207
Phone (718) 250-8789

831 Bedford Ave
Brooklyn, NY 11205

1311 Virginia St
Far Rockaway, NY 11691
Phone (718) 327-2908

9 Commons St
Rutland, VT 05701
Phone (802) 779-4321

725 Community Dr
Ste 302
South Burlington, VT 05403

Organizations & group practices 4

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 1

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": "1670803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1609587492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 GRAPE ST",
            "city": "FAIR HAVEN",
            "state": "VT",
            "postal_code": "057431049",
            "telephone_number": "802-772-7107",
            "fax_number": "802-772-9003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 CENTER ST STE 1-1",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014061",
            "telephone_number": "802-772-7107",
            "fax_number": "802-772-9003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVEREUX",
        "first_name": "TAMMY",
        "middle_name": "S",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-12",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "VT",
            "license": "101.0135875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rutland, VT

Sources for this page

Verify at the official NPI Registry.