Shirish D Devasthali, M.D.

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

38929 Issued in NC

Practice address

6387 Ramsey St
Suite 140
Fayetteville, NC 28311-9441

Phone

(910) 615-3829

Fax

(910) 615-6216

NPI assigned

Dec 19, 2006

Last updated

Jul 10, 2014By the provider in NPPES

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Blood and Cancer Clinic, PA

  • Non-Pharmacy Dispensing Site
  • Fayetteville, NC
  • NPI 1174747711
  NPD (past) Authorized official
• All American Rehabilitation Solutions

  dba Blood and Cancer Clinic, PA

  • Physical Therapist
  • Fayetteville, NC
  • NPI 1467455899
  NPD (past)

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404950400000",
    "number": "1851454995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1638 OWEN DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043424",
            "telephone_number": "910-615-6949",
            "fax_number": "910-615-9761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6387 RAMSEY ST",
            "address_2": "SUITE 140",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283119441",
            "telephone_number": "910-615-3829",
            "fax_number": "910-615-6216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVASTHALI",
        "first_name": "SHIRISH",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2014-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NC",
            "license": "38929",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "39131",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "28386",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8928386",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aira Bea Villapando Desvarro
• Kassidy Lyn Deuber, MOT OTR/L
• Gautam Dev, MD
• Christoffer Devantier, DMD
• Seema S Devasthali, PT
• Alfonso Deveyra III
• Anthea Deveyra, MS, OTR/L
• Tabitha Dew, NNP-BC
• Madison Dewil, PT, DPT
• Emily Dewitt, DNP

• Hematology & Oncology Physician in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Hematology & Oncology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2014; 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.