DR. INOKA ABEYSIRI DEVAPRIYA (NPI# 1629463864) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629463864 |
| Entity Type | Individual |
| Full Name | DR. INOKA ABEYSIRI DEVAPRIYA |
| Other Name | MISS INOKA ABEYSIRI SAMARASEKARA |
| Credential | MD |
| Practice Address |
100 Myrtle Blvd 103b Gracewood GA 30812 |
| Practice Telephone | 7067902011 |
| Mailing Telephone | 7067902011 |
| Enumeration Date | 2015-04-04 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | MT208551 | PA | Allopathic & Osteopathic Physicians |
| Y | 208D00000X | General Practice | 077723 | GA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 100 N Academy Ave, Danville, PA 178229800 | 5702716211 |
| Street Address |
100 MYRTLE BLVD 103B |
| City | GRACEWOOD |
| State | GA |
| Zip Code | 30812 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639166234 | Ga Department of Human Resources | Skilled Nursing Facility | 100 Myrtle Blvd, Gracewood, GA 30812-1500 | 2005-09-29 |
| 1104330398 | Sopheap Pin | Pharmacist | 100 Myrtle Blvd, Dept of Pharmacy, Gracewood, GA 30812 | 2017-11-27 |
| 1427434273 | Cynthia Bass Kucela | Pharmacist | 100 Myrtle Blvd, East Central Regional Hospital Dept of Pharmacy, Gracewood, GA 30812 | 2015-08-04 |
| 1013391119 | Hasim Momin | Dentist | 100 Myrtle Blvd, Gracewood, GA 30812 | 2015-07-17 |
| 1962720664 | Eliza A Myers | Dentist | 100 Myrtle Blvd, East Central Regional Hospital, Gracewood, GA 30812 | 2010-05-06 |
| 1992036909 | Department of Behavioral Health and Developmental Disabilities | Pharmacy | 100 Myrtle Blvd, Gracewood, GA 30812-1500 | 2010-01-15 |
| 1699000703 | Department of Behavioral Health and Developmental Disabilities | Intermediate Care Facility, Mentally Retarded | 100 Myrtle Blvd, Gracewood, GA 30812-1500 | 2009-10-07 |
| 1053646166 | Department of Behavioral Health and Developmental Disabilities | Skilled Nursing Facility | 100 Myrtle Blvd, Gracewood, GA 30812-1500 | 2009-10-07 |
| 1417165531 | Gail Cole Jackson | Pediatrics | 100 Myrtle Blvd, Gracewood, GA 30812-1500 | 2007-05-21 |
| 1982818845 | East Central Regional Hospital | Psychiatric Hospital | 100 Myrtle Blvd, Gracewood, GA 30812-1500 | 2007-05-10 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932571312 | Holli E Pender | Pharmacist | 100 Myrtle Blvd., Gracewood, GA 30812 | 2015-10-26 |
| 1295163277 | Melissa B Lynch | Contractor | 1523 Keron Way, Gracewood, GA 30812 | 2013-10-29 |
| 1043822067 | Marla Marie Mitcham | Pharmacist | 100 Myrtle Blvd., Pharmacy Bldg. 15 Room G12, Gracewood, GA 30812 | 2020-08-20 |
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.