Devan Bradley Blue, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P17073 Issued in NC

Practice address

923 W 3Rd St
Pembroke, NC 28372-9628

Phone

(910) 521-7306

Fax

(910) 521-7406

NPI assigned

Mar 15, 2023

Last updated

Mar 15, 2023By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1678838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1962103135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "923 W 3RD ST",
            "city": "PEMBROKE",
            "state": "NC",
            "postal_code": "283729628",
            "telephone_number": "910-521-7306",
            "fax_number": "910-521-7406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "923 W 3RD ST",
            "city": "PEMBROKE",
            "state": "NC",
            "postal_code": "283729628",
            "telephone_number": "910-521-7306",
            "fax_number": "910-521-7406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUE",
        "first_name": "DEVAN",
        "middle_name": "BRADLEY",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-15",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P17073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cassandra Renee Benoit, OTR/L
• Martha Elizabeth Berry
• Karen Rose Betz, PA
• Bewell Family Practice, PLLC
• Bio-Medical Applications of North Carolina, Inc. (Fresenius Medical Care Pembroke)
• Janya Boatwright
• Alexis Bost
• Elaine Deese Brewington
• Tasha Ivey Brooks, FNP-C
• Alfred Bryant Jr., PH.D., LPC

• Physical Therapist in Pembroke, NC
• Providers in Pembroke, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.