Individual provider Active NPI

Devon Lagrace Casida, FNP-C

  • Nurse Practitioner
  • Fresno, CA
National Provider Identifier
1922586643
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95009510 Issued in CA
Practice address
1233 W Shaw Ave Ste 103
Fresno, CA 93711-3718
Phone
(559) 284-4794
NPI assigned
Aug 3, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95009510 CA
Nurse Practitioner 363L00000X 95009510 CA Primary

Addresses

Primary practice location

1233 W Shaw Ave Ste 103
Fresno, CA 93711-3718

Mailing address

1233 W Shaw Ave Ste 103
Fresno, CA 93711-3718
Phone (559) 206-7680

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181003002288 CA Practitioner - Nurse Practitioner 5092067983 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Restorative Health and Wellness IncGroup PAC ID 7719323534, 4 clinicians

Practice addresses (Care Compare)

7125 N Chestnut Ave
Suite 101
Fresno, CA 93720-0358
Phone (209) 364-9461

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95009510CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Restorative Health & Wellness Inc CurrentSince Nov 1, 2022 Accepting new patients

Locations

7125 N Chestnut Ave
Ste 101
Fresno, CA 93720
Phone (209) 364-9461

1233 W Shaw Ave
Ste 103
Fresno, CA 93711
Phone (559) 206-7680

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1533254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1922586643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1233 W SHAW AVE STE 103",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937113718",
            "telephone_number": "559-206-7680",
            "fax_number": "559-206-7230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1233 W SHAW AVE STE 103",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937113718",
            "telephone_number": "559-284-4794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASIDA",
        "first_name": "DEVON",
        "middle_name": "LAGRACE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-03",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95009510",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95009510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.