Active NPI
Dennis F Devereux, M.D.
- Surgery Physician
- Albemarle, NC
National Provider Identifier
1770563355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 2006-01764
- Practice address
- 105 Yadkin St
Suite 203
Albemarle, NC 28001-3449 - Phone
- (704) 982-0161
- NPI assigned
- Jan 19, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 2006-01764 | NC | Primary |
Addresses
Primary practice location
105 Yadkin St
Suite 203
Albemarle, NC 28001-3449
Mailing address
PO Box 601888
Charlotte, NC 28260-1888
Phone (704) 982-0161
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5906239 | Medicaid | NC | |
| 1770563355 | Medicaid | NC | |
| 144W1 | Other | NC | BCBS |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2006-01764 | NC | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saint Francis Hospital / Medicine | Past | Accepting new patients | |
| Carolinas Physicians Network, Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba Carolinas HealthCare System Virtual Visit
- Family Medicine Physician
- Charlotte, NC
- NPI 1578939914
-
- Hospitalist Physician
- Poughkeepsie, NY
- NPI 1528167442
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485734400000",
"number": "1770563355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 601888",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282601888",
"telephone_number": "704-982-0161"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 YADKIN ST",
"address_2": "SUITE 203",
"city": "ALBEMARLE",
"state": "NC",
"postal_code": "280013449",
"telephone_number": "704-982-0161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEVEREUX",
"first_name": "DENNIS",
"middle_name": "F",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-19",
"last_updated": "2017-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NC",
"license": "2006-01764",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5906239",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1770563355",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "144W1",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Albemarle, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.