Active NPI
Matthew Zane Devazier
- Pharmacist
- Collierville, TN
National Provider Identifier
1689326647
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 45369
- Practice address
- 824 W Poplar Ave
Collierville, TN 38017-2579 - Phone
- (901) 853-3714
- NPI assigned
- Jan 21, 2022
- Last updated
- Jan 21, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 45369 | TN | Primary |
Addresses
Primary practice location
824 W Poplar Ave
Collierville, TN 38017-2579
Mailing address
824 W Poplar Ave
Collierville, TN 38017-2579
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | 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": "1642723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642723200000",
"number": "1689326647",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "824 W POPLAR AVE",
"city": "COLLIERVILLE",
"state": "TN",
"postal_code": "380172579"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "824 W POPLAR AVE",
"city": "COLLIERVILLE",
"state": "TN",
"postal_code": "380172579",
"telephone_number": "901-853-3714"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEVAZIER",
"first_name": "MATTHEW",
"middle_name": "ZANE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-01-21",
"last_updated": "2022-01-21",
"certification_date": "2022-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "45369",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Collierville, TN
- Ariana Demetropoulos, DMD
- Lindsey Therese Denson Carr, DC
- Dental Implant Aesthetic Center (Oral and Facial Surgical Specialists)
- Dwana Jeane Desanctis, PT
- Jill Suzanne Detty Oswaks, DNSC
- Phyllis A Dickinson-Branch, DDS
- Jacqualine Drake Dickson, FNP - C
- Nicholas Alexander Diloreto
- Jeffrey A Dlabach, M.D.
- Nicole D Dotson
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.