John B. Devries, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

05013050A Issued in IN

Practice address

2310 California Rd Ste a
Elkhart, IN 46514-1228

Phone

(574) 206-1401

Fax

(574) 262-5183

NPI assigned

Aug 7, 2018

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Freedom Physical Therapy and Wellness LLC

  • Physical Therapist
  • Elkhart, IN
  • NPI 1184341349
  NPD Authorized official
• ASC Surgical Ventures, LLC

  • Ambulatory Surgical Clinic/Center
  • Elkhart, IN
  • NPI 1083715148
  NPD (past)

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

{
    "created_epoch": "1533600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575331200000",
    "number": "1619456050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 CALIFORNIA RD STE A",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465141228",
            "telephone_number": "574-206-1401",
            "fax_number": "574-262-5183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 CALIFORNIA RD STE A",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465141228",
            "telephone_number": "574-206-1401",
            "fax_number": "574-262-5183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVRIES",
        "first_name": "JOHN",
        "middle_name": "B.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-07",
        "last_updated": "2019-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05013050A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300017809",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mallory Dennis
• Dental Professionals of in, PC
• Dental Professionals of Indiana, P.C.
• Melissa Derflinger
• Todd Michael Deuel
• Jazlien Dewitt
• Cassandra Jane Dewulf, FNP-C
• Jared Ray Dhaemers, MD
• Jaspaul Dhanota, MD
• Chris Dhoore, RPH

• Physical Therapist in Elkhart, IN
• Providers in Elkhart, IN by specialty
• Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2019; 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.