Active NPI
Devolia Wilson-Johnson
- Home Health Aide
- Saint Paul, MN
National Provider Identifier
1730579004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- Practice address
- 525 Sherburne Ave
Saint Paul, MN 55103-1946 - Phone
- (702) 277-9361
- NPI assigned
- Jan 26, 2015
- Last updated
- Aug 19, 2020
- 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 |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | NU | Primary |
Addresses
Primary practice location
525 Sherburne Ave
Saint Paul, MN 55103-1946
Mailing address
1241 Appaloosa Hills Ave
North Las Vegas, NV 89081-3323
Phone (702) 466-0463
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1405013329 | Medicaid | NV |
Other names 1
- Devolia Wilson
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | warmheartshcllc@outlook.com | Direct |
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": "1422230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597795200000",
"number": "1730579004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1241 APPALOOSA HILLS AVE",
"city": "NORTH LAS VEGAS",
"state": "NV",
"postal_code": "890813323",
"telephone_number": "702-466-0463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "525 SHERBURNE AVE",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551031946",
"telephone_number": "702-277-9361"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON-JOHNSON",
"first_name": "DEVOLIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-01-26",
"last_updated": "2020-08-19",
"certification_date": "2020-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1405013329",
"state": "NV"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "warmheartshcllc@outlook.com",
"affiliation": "N",
"endpointDescription": "warmheartshcllc@outlook.com",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "SAINT PAUL",
"address_1": "525 Sherburne Ave",
"city": "Saint Paul",
"state": "MN",
"country_code": "US",
"postal_code": "551031946",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "DEVOLIA",
"last_name": "WILSON",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.