Individual provider Active NPI

Tony Devaun McNeil

  • Peer Specialist
  • Lewiston, ID
National Provider Identifier
1639021462
Registry record updated Feb 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
1630 23Rd Ave BLDG 2
Lewiston, ID 83501-6350
Phone
(208) 746-7784
Fax
(208) 798-8652
NPI assigned
Feb 12, 2026
Last updated
Feb 12, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X Primary

Addresses

Primary practice location

1630 23Rd Ave BLDG 2
Lewiston, ID 83501-6350

Mailing address

1630 23Rd Ave
Lewiston, ID 83501-6350
Phone (208) 746-7784

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1770854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770854400000",
    "number": "1639021462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 23RD AVE",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835016350",
            "telephone_number": "208-746-7784",
            "fax_number": "208-798-8652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 23RD AVE BLDG 2",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835016350",
            "telephone_number": "208-746-7784",
            "fax_number": "208-798-8652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNEIL",
        "first_name": "TONY",
        "middle_name": "DEVAUN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-02-12",
        "last_updated": "2026-02-12",
        "certification_date": "2026-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2026; 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.