Active NPI
Carol A Devito, P.A.
- Physician Assistant
- Fresno, CA
National Provider Identifier
1700901717
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 13777
- Practice address
- 2555 S East Ave
Fresno, CA 93706-5104 - Phone
- (615) 778-4066
- NPI assigned
- Mar 20, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 13777 | CA | Primary |
Addresses
Primary practice location
2555 S East Ave
Fresno, CA 93706-5104
Mailing address
5080 Spectrum Dr
Suite 1200 West
Addison, TX 75001-4648
Phone (972) 364-8000
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13777 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1254873600000",
"number": "1700901717",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5080 SPECTRUM DR",
"address_2": "SUITE 1200 WEST",
"city": "ADDISON",
"state": "TX",
"postal_code": "750014648",
"telephone_number": "972-364-8000",
"fax_number": "214-775-4502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2555 S EAST AVE",
"city": "FRESNO",
"state": "CA",
"postal_code": "937065104",
"telephone_number": "615-778-4066"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEVITO",
"first_name": "CAROL",
"middle_name": "A",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-20",
"last_updated": "2009-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "13777",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.