SHANE BRENNA DEVINE DO NPI 1245033471

NPI Information

  • NPI: 1245033471
  • Provider Name: SHANE BRENNA DEVINE, DO
  • Classification: Student in an Organized Health Care Education/Training Program - 390200000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 88TH MEDICAL GROUP
    4881 SUGAR MAPLE DR.
    WPAFB, OH
    ZIP 45433
  • Phone: (937) 257-0837

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NPI Details

Shane Brenna Devine, DO is a student in an organized health care education training program in Wpafb, OH. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. Shane Brenna Devine, DO NPI is 1245033471. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

88TH MEDICAL GROUP
4881 SUGAR MAPLE DR.
WPAFB, OH
ZIP 45433
Phone: (937) 257-0837

The NPI 1245033471 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/31/2025 and was last updated on 8/18/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1171000000XMilitary Health Care Provider58.03828OHIONo
2390200000XStudent in an Organized Health Care Education/Training Program58.03828OHIOYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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