DR. PRAKASH P DEVASKAR (NPI# 1912079294) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912079294 |
| Entity Type | Individual |
| Full Name | DR. PRAKASH P DEVASKAR |
| Credential | MD |
| Practice Address |
700 River Dr Fort Bragg CA 95437-5403 |
| Practice Telephone | 7079614631 |
| Practice Fax Number | 7079641192 |
| Mailing Telephone | 7079614631 |
| Mailing Fax Number | 7079641192 |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2012-10-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | CA00A350680 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 68-0326919 | 05 | |
| CALIFORNIA STATE LIC | 00A350680 | 01 | |
| DEA | AD9568481 | 01 |
| Street Address |
700 RIVER DR |
| City | FORT BRAGG |
| State | CA |
| Zip Code | 95437-5403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306896428 | John A Kermen | Anesthesiology | 700 River Dr, Fort Bragg, CA 95437-5403 | 2006-05-11 |
| 1710336300 | Glass Beach Medical Services A Medical Corporation | Emergency Medicine | 700 River Dr, Fort Bragg, CA 95437-5403 | 2016-06-06 |
| 1447585245 | Mark David Levine Md, Fort Bragg Professional Corporation | Psychiatry & Neurology | 700 River Dr, Fort Bragg, CA 95437-5403 | 2009-10-12 |
| 1962666313 | Donald Sheffel, M.d. | Surgery | 700 River Dr, Fort Bragg, CA 95437-5403 | 2008-07-15 |
| 1891982351 | Lois Faith Leister | Pharmacist | 700 River Dr, Mendocino Coast District Hospital Pharmacy, Fort Bragg, CA 95437-5403 | 2007-09-28 |
| 1659562742 | Marilyn Magoffin | Nurse Practitioner | 700 River Dr, Fort Bragg, CA 95437-5403 | 2007-08-05 |
| 1255540340 | Phillip Conwell | Registered Nurse | 700 River Dr, Fort Bragg, CA 95437-5403 | 2007-05-22 |
| 1013060516 | Stephen Pinsk, M.d., Inc. | Clinical Medical Laboratory | 700 River Dr, Fort Bragg, CA 95437-5403 | 2007-01-19 |
| 1477641686 | Tamaki A. Myers | Emergency Medicine | 700 River Dr, Fort Bragg, CA 95437-5403 | 2006-10-11 |
| 1366535890 | Andrea Mccullough | Emergency Medicine | 700 River Dr, Fort Bragg, CA 95437-5403 | 2006-10-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902357437 | Mendocino Coast Hospitality Center | Community/Behavioral Health | 137 E. Oak Street, Fort Bragg, CA 95437 | 2016-10-19 |
| 1144604570 | Erin Paul | Community Health Worker | 474 South Franklin Street, Fort Bragg, CA 95437 | 2015-07-15 |
| 1508125790 | Joel Macgregor Green | Marriage & Family Therapist | 331- G Redwood Ave., Fort Bragg, CA 95437 | 2012-05-09 |
| 1013244102 | Jenna Glasscock | Counselor | 331 E Redwood Ave, Ste E, Fort Bragg, CA 95437 | 2009-11-10 |
| 1770819641 | Patrick Lenaghan | Emergency Medicine | 707 River Dr, Fort Bragg, CA 95437 | 2009-10-27 |
| 1043455827 | M. Lee Baker | Dentist | 890 River Dr, Fort Bragg, CA 95437 | 2008-12-09 |
| 1528250495 | Christine Anne Samas | Social Worker | 656a Harrison St., Fort Bragg, CA 95437 | 2007-08-15 |
| 1083822811 | Katharine L. White | Marriage & Family Therapist | 137 E Oak Street, Fort Bragg, CA 95437 | 2007-05-17 |
| 1053525873 | Marty Christine Johnson | Marriage & Family Therapist | 331 E. Redwood Ave, Fort Bragg, CA 95437 | 2007-05-10 |
| 1528114741 | Kate Teresa Donohue | Psychologist | 19201 Noyo Acres Dr, Fort Bragg, CA 95437 | 2007-01-29 |
| Find all providers in zip 95437 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629360250 | Eric Russell Sigmon | Pediatrics | Womack Army Medical Center 2817 Reilly Road, Fort Bragg, NC 28310-0001 | 2011-05-16 |
| 1306979570 | Kathleen Dunn Farr | Pediatrics | Jsomtc Usajfkswcs, 2175 Reilly Road, Stop A, Fort Bragg, NC 28310-5000 | 2007-03-14 |
| 1841225539 | Janice Elaine Katz | Pediatrics | Robinson Health Clinic Womack Ctr, Building C1722 Tagatay Street, Fort Bragg, NC 28310-0001 | 2006-07-11 |
| 1346204443 | Damaris Padilla | Pediatrics | 2864 Woodruff St, Fort Bragg, NC 28310-0001 | 2006-04-14 |
| 1932178449 | Christopher Robshaw | Pediatrics | 510 Cypress St Ste D, Fort Bragg, CA 95437-5411 | 2006-03-16 |
| 1124094248 | Richard K Kynion | Pediatrics | Department of Pediatrics, Womack Army Medical Center, Fort Bragg, NC 28310-0001 | 2006-02-28 |
| 1215909551 | Ursula Yvette Chesney-grady | Pediatrics | Wamc Stop A Mcxc Dop, 2817 Reilly Road, Fort Bragg, NC 28310-5000 | 2006-02-02 |
| 1629060850 | Marie Nelson | Pediatrics | Bastogne St Bldg 5-4257, Fort Bragg, NC 28310-0001 | 2005-08-15 |
| 1063824324 | Ann Didomenico Schilling | Pediatrics | 2817 Reilly St, Fort Bragg, NC 28310 | 2014-05-21 |
| 1235578600 | Stephanie Ann Berdy | Pediatrics | 2817 Reilly St, Fort Bragg, NC 28310-0004 | 2013-06-19 |
| Find all providers in FORT BRAGG | ||||
| City | FORT BRAGG |
| Zip Code | 95437 |
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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.