Active NPI
Devin Demyanovich, ATC
- Athletic Trainer
- Durham, NC
National Provider Identifier
1760018113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- LAT-1712
- Practice address
- 110 Whitford Drive WD Murray Building RM 212
Durham, NC 27708-0001 - Phone
- (919) 668-5626
- Fax
- (919) 684-9981
- NPI assigned
- Mar 18, 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | LAT-1712 | NC | Primary |
Addresses
Primary practice location
110 Whitford Drive WD Murray Building RM 212
Durham, NC 27708-0001
Mailing address
1304 Cozart St Unit 217
Durham, NC 27704-6219
Phone (570) 778-6385
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Citrix.duke.edu | Health Information Exchange (HIE) | Duke University Health System Inc |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LAT-1712 | NC | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1584489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701043200000",
"number": "1760018113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1304 COZART ST UNIT 217",
"city": "DURHAM",
"state": "NC",
"postal_code": "277046219",
"telephone_number": "570-778-6385"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 WHITFORD DRIVE WD MURRAY BUILDING RM 212",
"city": "DURHAM",
"state": "NC",
"postal_code": "277080001",
"telephone_number": "919-668-5626",
"fax_number": "919-684-9981"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEMYANOVICH",
"first_name": "DEVIN",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-18",
"last_updated": "2023-11-27",
"certification_date": "2020-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NC",
"license": "LAT-1712",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Citrix.duke.edu",
"affiliation": "Y",
"endpointDescription": "Hardlined computer",
"affiliationName": "Duke University Health System Inc",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "110 Whitford Drive Wd Murray Building Rm 212",
"city": "Durham",
"state": "NC",
"country_code": "US",
"postal_code": "277080001",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.