Dwayne R Depry, DO

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

20A9403 Issued in CA

Practice address

1221 E Spruce Ave
Fresno, CA 93720

Phone

(559) 261-2799

Fax

(559) 261-2796

NPI assigned

Nov 1, 2006

Sex

Male

Sole proprietor

No

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Department of Veterans Affairs of the State of CaliforniaGroup PAC ID 6507099520, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Department of Veterans Affairs of the State of California

  • Skilled Nursing Facility
  • Redding, CA
  • NPI 1396165353
  Medicare reassignment Care Compare group NPD
• Department of Veterans Affairs of the State of California

  • Skilled Nursing Facility
  • Fresno, CA
  • NPI 1770903775
  NPD
• Department of Veterans Affairs of the State of California

  • Skilled Nursing Facility
  • Los Angeles, CA
  • NPI 1821316076
  NPD

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619055118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 E SPRUCE AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93720",
            "telephone_number": "559-261-2799",
            "fax_number": "559-261-2796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 E SPRUCE AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93720",
            "telephone_number": "559-261-2799",
            "fax_number": "559-261-2796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPRY",
        "first_name": "DWAYNE",
        "middle_name": "R",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "20A9403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Department of Veterans Affairs
• Department of Veterans Affairs
• Department of Veterans Affairs of the State of California
• Dependable Transport
• Emil J Deprima, PHARM D
• Tu Quynh Depry, DO
• Juan Alfredo Deras Espinoza, MD
• Ani Hagop Derboghossian, PHARMD
• Haig Derboghossian
• Jason Derhovanesian, DO

• Psychiatry Physician in Fresno, CA
• Providers in Fresno, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.