Jo Bayliss Devivo, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110009528 Issued in VA

Practice address

163 Thomas Johnson Dr Ste H
Frederick, MD 21702-4673

Phone

(301) 694-9111

NPI assigned

Sep 7, 2023

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

Other names 1

• Jo Bayliss Baslot Former name

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1694044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709251200000",
    "number": "1992581532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11107 ROCK GARDEN DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220304935",
            "telephone_number": "843-618-8457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 THOMAS JOHNSON DR STE H",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024673",
            "telephone_number": "301-694-9111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5695 King Centre Dr Ste 303",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223155748",
            "country_code": "US",
            "telephone_number": "843-618-8457",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEVIVO",
        "first_name": "JO",
        "middle_name": "BAYLISS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-07",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110009528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JO",
            "last_name": "BASLOT",
            "middle_name": "BAYLISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Stephanie King Desmond, LGPC
• Leena Shrivastava Dev, MD
• Developmental Community Services Inc
• Developmental Community Services Inc
• Elizabeth G Devilbiss, LCPC
• Frances Kathleen Devlin, RN
• Cassandra Lynn Devries, D.C.
• Devan Dewees
• Victoria Rose Dewey
• Megan Margaret Dewing, MT-BC

• Physician Assistant in Frederick, MD
• Providers in Frederick, MD by specialty
• Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.