Individual provider Active NPI

Devon Dylla, FNP

  • Family Nurse Practitioner
  • La Vernia, TX
National Provider Identifier
1770306698
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1179660 Issued in TX
Practice address
101 Woodbridge Dr.
Building B, Ste 101
La Vernia, TX 78121
Phone
(830) 581-8027
NPI assigned
Nov 7, 2024
Last updated
Nov 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1179660 TX Primary

Addresses

Primary practice location

101 Woodbridge Dr.
Building B, Ste 101
La Vernia, TX 78121

Mailing address

PO Box 625
Floresville, TX 78114-0625

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241217002307 TX Practitioner - Nurse Practitioner 0648707596 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Roderick D. Ekmark, MD, PA CurrentSince Nov 12, 2024 Accepting new patients

Organizations & group practices 1

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": "1730937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1770306698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 625",
            "city": "FLORESVILLE",
            "state": "TX",
            "postal_code": "781140625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 WOODBRIDGE DR.",
            "address_2": "BUILDING B, STE 101",
            "city": "LA VERNIA",
            "state": "TX",
            "postal_code": "78121",
            "telephone_number": "830-581-8027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYLLA",
        "first_name": "DEVON",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-07",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1179660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Vernia, TX

Sources for this page

Verify at the official NPI Registry.