Individual provider Active NPI

Devon McCluskey

  • School Registered Nurse
  • Glendale, AZ
National Provider Identifier
1962190066
Registry record updated Apr 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
284699 Issued in AZ
Practice address
6315 W Port Au Prince LN
Glendale, AZ 85306-3217
Phone
(623) 412-4550
NPI assigned
Apr 26, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 284699 AZ Primary

Addresses

Primary practice location

6315 W Port Au Prince LN
Glendale, AZ 85306-3217

Mailing address

6315 W Port Au Prince LN
Glendale, AZ 85306-3217

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
284699AZMDSchool Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1682467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682467200000",
    "number": "1962190066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6315 W PORT AU PRINCE LN",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853063217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6315 W PORT AU PRINCE LN",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853063217",
            "telephone_number": "623-412-4550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLUSKEY",
        "first_name": "DEVON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-26",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "AZ",
            "license": "284699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 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.