David F Devries, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

515-023 Issued in WI

Practice address

2483 Corporate Cir
East Troy, WI 53120-2575

Phone

(262) 642-2000

NPI assigned

Aug 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Wisconsin Physician Services SC

  • Emergency Medicine Physician
  • Watertown, WI
  • NPI 1558818492
  NPD

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1831204080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 W FOREST HOME AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532152843",
            "telephone_number": "414-647-6326",
            "fax_number": "414-671-8860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2483 CORPORATE CIR",
            "city": "EAST TROY",
            "state": "WI",
            "postal_code": "531202575",
            "telephone_number": "262-642-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVRIES",
        "first_name": "DAVID",
        "middle_name": "F",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "515-023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42937600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Irene Corzo, LCPC
• Richard Datka, APRN
• Tracy Davies, DDS
• Jody L Deboer, MSW, LCSW
• Vivian L Dehahn, APNP
• East Troy Area Emergency Services District
• East Troy Community School District
• East Troy Family Dental Center SC
• Rachel Marie Eaton, RN BSN
• Family Medicine & Surgery LLC

• Physician Assistant in East Troy, WI
• Providers in East Troy, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.