Lisa Ann Devereaux, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

2249301 Issued in NY

Practice address

1001 Eleventh Street
Room 172 Trott Access Center
Niagara Falls, NY 14301

Phone

(716) 278-8110

Fax

(716) 278-8111

NPI assigned

Jan 18, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• County of Niagara

  • Community/Behavioral Health Agency
  • Niagara Falls, NY
  • NPI 1285774083
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811040660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 ELEVENTH STREET",
            "address_2": "ROOM 172 TROTT ACCESS CENTER",
            "city": "NIAGARA FALLS",
            "state": "NY",
            "postal_code": "14301",
            "telephone_number": "716-278-8110",
            "fax_number": "716-278-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 ELEVENTH STREET",
            "address_2": "ROOM 172 TROTT ACCESS CENTER",
            "city": "NIAGARA FALLS",
            "state": "NY",
            "postal_code": "14301",
            "telephone_number": "716-278-8110",
            "fax_number": "716-278-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVEREAUX",
        "first_name": "LISA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "2249301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffery A. Derose, DDS
• Anny Descoteaux, RNFA
• Margaret A Desmarais, FNP
• Max Destino
• Lauren C. Devantier, DDS
• Manvir Dhanjal
• Satnam Singh Dhillon
• Emily Diaz
• Mya Marie Diaz
• Anita Maria Dibella, RN

• Licensed Practical Nurse in Niagara Falls, NY
• Providers in Niagara Falls, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.