Devon Ragan, LLC
Organization Active NPI Nutritionist · Conowingo, MD
NPI 1801609201 · NPPES record last updated Jan 29, 2025
Key facts
- NPI
- 1801609201
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Nutritionist 133N00000X
- Legal business name
- DEVON RAGAN, LLC
- Practice address
- 432 Johnson Rd
Conowingo, MD 21918-1325 - Phone
- (443) 747-1071
- NPI assigned
- Jan 29, 2025
- Organization subpart
- No
Authorized official
- Name
- Devon Ragan, CNS
- Title
- Nutritionist
- Phone
- (443) 747-1071
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20251022003818 | MD | Part B Supplier - Clinic/Group Practice | 7113415001 |
Receives reassigned benefits from 1 practitioner Practice locations: Conowingo, MD |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutritionist |
133N00000X | Yes |
Addresses
Primary practice location
432 Johnson Rd
Conowingo, MD 21918-1325
Mailing address
432 Johnson Rd
Conowingo, MD 21918-1325
Phone (443) 747-1071
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366054777 | Other | NPPES |
Other providers in Conowingo, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 29, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.