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1376581090 NPI number — MARY K DEVERS MD

NPI Number: 1376581090
Health Care Provider/Practitioner: MARY K DEVERS MD

Information about “1376581090” NPI (MARY K DEVERS MD) exists in 1376581090 in HTML format HTML  |  1376581090 in plain Text format TXT  |  1376581090 in PDF (Portable Document Format) PDF  |  1376581090 in an XML format XML  formats.

NPI Number : 1376581090 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1376581090",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DEVERS",
    "FirstName": "MARY",
    "MiddleName": "K",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "WINKELMANN",
    "OtherFirstName": "MARY",
    "OtherMiddleName": "K",
    "OtherNamePrefix": "MISS",
    "OtherNameSuffix": null,
    "OtherCredential": "MD",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "5701 W 119TH ST",
    "SecondLineMailingAddress": "SUITE 330",
    "MailingAddressCityName": "OVERLAND PARK",
    "MailingAddressStateName": "KS",
    "MailingAddressPostalCode": "66209-3721",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "913-345-3650",
    "MailingAddressFaxNumber": "913-345-3797",
    "FirstLinePracticeLocationAddress": "5701 W 119TH ST",
    "SecondLinePracticeLocationAddress": "SUITE 330",
    "PracticeLocationAddressCityName": "OVERLAND PARK",
    "PracticeLocationAddressStateName": "KS",
    "PracticeLocationAddressPostalCode": "66209-3721",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "913-345-3650",
    "PracticeLocationAddressFaxNumber": "913-345-3797",
    "EnumerationDate": "06/03/2006",
    "LastUpdateDate": "05/07/2011",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207Q00000X",
        "TaxonomyName": "Family Medicine Physician",
        "LicenseNumber": "0428486",
        "LicenseNumberStateCode": "KS",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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