Provider Demographics
NPI:1114942299
Name:DEVINE, JAMES D (OD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:D
Last Name:DEVINE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7930 O ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-2500
Mailing Address - Country:US
Mailing Address - Phone:402-420-2020
Mailing Address - Fax:402-323-2002
Practice Address - Street 1:7930 O ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-2500
Practice Address - Country:US
Practice Address - Phone:402-420-2020
Practice Address - Fax:402-323-2002
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NENE894152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE36129OtherBCBS
NE0553580001Medicare NSC
NET77026Medicare UPIN
NE267938Medicare PIN