Carol Derwacter, C.N.P.

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

NP04044 Issued in OH

Practice address

2945 Maple Ave
Zanesville, OH 43701-1753

Phone

(740) 454-0196

Fax

(740) 454-7834

NPI assigned

Dec 19, 2005

Sex

Female

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 6

Medicare fee-for-service enrollment

Enrolled in OH

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

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

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219104000000",
    "number": "1619953924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 BETHESDA DR",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437011800",
            "telephone_number": "740-454-4651",
            "fax_number": "740-454-4653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2945 MAPLE AVE",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437011753",
            "telephone_number": "740-454-0196",
            "fax_number": "740-454-7834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERWACTER",
        "first_name": "CAROL",
        "credential": "C.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-19",
        "last_updated": "2008-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "NP04044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "DENP03501",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICAID",
            "identifier": "0989499",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2043354",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE PIN",
            "identifier": "311413469060",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "080146341",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE RAILROAD",
            "identifier": "CA1586",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allison B Dennis, BA, LPC
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• Kiera Jane Dennis, L.P.N
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• Ashley N. Devoll
• Brittany Dawn Devoll, LPN
• Kiley Devoll
• Michelle Lynne Devoll, AGACNP

• Adult Health Nurse Practitioner in Zanesville, OH
• Providers in Zanesville, OH by specialty
• Adult Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.