Individual provider Active NPI

John Deverter, M.D.

  • Psychiatry Physician
  • Lynchburg, VA
National Provider Identifier
1619069408
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
0101023850 Issued in VA
Practice address
2215 Langhorne Rd
Suite 104
Lynchburg, VA 24501-1121
Phone
(434) 455-3047
Fax
(434) 948-4918
NPI assigned
Sep 29, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 0101023850 VA Primary

Addresses

Primary practice location

2215 Langhorne Rd
Suite 104
Lynchburg, VA 24501-1121

Mailing address

2215 Langhorne Rd
Suite 104
Lynchburg, VA 24501-1121
Phone (434) 455-3047

Other identifiers 3

IdentifierTypeStateIssuer
004945441MedicaidVA
260001465OtherVAUNITED HEALTH CARE
259448OtherVAANTHEM BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Total Life Counseling, Inc. Past Accepting new patients
Horizon Behavioral Health PastSince May 21, 2011 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619069408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 LANGHORNE RD",
            "address_2": "SUITE 104",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245011121",
            "telephone_number": "434-455-3047",
            "fax_number": "434-948-4918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 LANGHORNE RD",
            "address_2": "SUITE 104",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245011121",
            "telephone_number": "434-455-3047",
            "fax_number": "434-948-4918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVERTER",
        "first_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101023850",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004945441",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "260001465",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE SHIELD",
            "identifier": "259448",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynchburg, VA

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.