Teresa E Devine, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

2017042803 Issued in MO

Practice address

4800 Mexico Rd Ste 101
Saint Peters, MO 63376-1666

Phone

(636) 442-5035

Fax

(636) 442-5036

NPI assigned

Sep 14, 2018

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

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1536883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536883200000",
    "number": "1912480955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 MEXICO RD STE 101",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633761666",
            "telephone_number": "636-442-5035",
            "fax_number": "636-442-5036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 MEXICO RD STE 101",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633761666",
            "telephone_number": "636-442-5035",
            "fax_number": "636-442-5036"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1055 Bowles Ave Ste 202",
            "address_purpose": "LOCATION",
            "city": "Fenton",
            "state": "MO",
            "postal_code": "630262308",
            "country_code": "US",
            "telephone_number": "636-496-3900",
            "fax_number": "636-496-3939",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEVINE",
        "first_name": "TERESA",
        "middle_name": "E",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-14",
        "last_updated": "2018-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2017042803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Lynn Desy, CRNA
• Dettenmeier Chiropractic LLC
• Adam Dettenmeier, DC
• Paige Devening
• Madeline Ann Devereux
• Jaimie Devoy
• Carriss Dewitt, MA, PLPC
• Dierbergs Markets Inc
• Dierbergs Markets Inc
• Digestive Disorder Center of St. Charles County, Inc

• All providers in Saint Peters, MO
• Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2018; 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.