Active NPI
William Francis Devine, PMHNP-BC
- Psychiatric/Mental Health Nurse Practitioner
- Lake Havasu City, AZ
National Provider Identifier
1760766208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 229481
- Practice address
- 2187 Swanson Ave
Lake Havasu City, AZ 86403-6838 - Phone
- (928) 855-3432
- NPI assigned
- Oct 3, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 2008006146 | MO | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 2018025246 | MO | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 229481 | AZ | Primary |
Addresses
Primary practice location
2187 Swanson Ave
Lake Havasu City, AZ 86403-6838
Mailing address
166 Christina Marie Dr
O Fallon, MO 63368-7872
Phone (314) 443-9228
Other practice location 1
5000 Cedar Plaza Pkwy Ste 350
Saint Louis, MO 63128-3859
Phone (314) 843-4333
Other practice location 2
500 Indiana Ave
Winslow, AZ 86047-2169
Phone (928) 289-4646 ext. 28170
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 498748 | Medicaid | AZ |
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
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1317600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600646400000",
"number": "1760766208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "166 CHRISTINA MARIE DR",
"city": "O FALLON",
"state": "MO",
"postal_code": "633687872",
"telephone_number": "314-443-9228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2187 SWANSON AVE",
"city": "LAKE HAVASU CITY",
"state": "AZ",
"postal_code": "864036838",
"telephone_number": "928-855-3432"
}
],
"practiceLocations": [
{
"address_1": "5000 Cedar Plaza Pkwy Ste 350",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631283859",
"country_code": "US",
"telephone_number": "314-843-4333",
"fax_number": "314-843-4856",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "500 Indiana Ave",
"address_purpose": "LOCATION",
"city": "Winslow",
"state": "AZ",
"postal_code": "860472169",
"country_code": "US",
"telephone_number": "928-289-4646 x28170",
"fax_number": "928-289-6225",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DEVINE",
"first_name": "WILLIAM",
"middle_name": "FRANCIS",
"name_prefix": "Mr.",
"credential": "PMHNP-BC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-10-03",
"last_updated": "2020-09-21",
"certification_date": "2020-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MO",
"license": "2008006146",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "MO",
"license": "2018025246",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "AZ",
"license": "229481",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "498748",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lake Havasu City, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.