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Deactivated NPI 1205643640 Deactivated / Inactive NPI Female Practitioner

Mildred Trammell Devontenno , NURSE

Licensed Practical Nurse • Shaker Heights, OH

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Mildred Trammell Devontenno has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date December 17, 2024
NPI Deactivation Date June 03, 2025
Total Practice Duration ~1 Years of Practice (2024 – 2025)

Professional Overview & Biography Verified Profile Summary

Mildred Trammell Devontenno, NURSE was a registered Licensed Practical Nurse practicing in Shaker Heights, OH. Throughout an active medical career spanning 1 years, Mildred Trammell Devontenno provided care at the practice location at 3550 NORTHFIELD RD until profile deactivation on 2025-06-03.

Practice Location & Contact Primary Location

Practice Address

3550 Northfield Rd

Shaker Heights, OH 441225253

Telephone 2167525600
Associated Practice Facility / Clinic
🏢 Shaker Heights, Ltc, Llc Facility NPI 1033250451

Specialty Benchmarks & Practice Insights

Comparative analytics for Licensed Practical Nurse in Shaker Heights, OH

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 14.0 Yrs
Regional Practice Density
20 Specialists

Practicing in Shaker Heights, OH (13034 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Licensed Practical Nurse Primary Specialty

NUCC Taxonomy Code: 164W00000X

State License OH 151367

An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Brent Myers

Speech-Language Pathologist

NPI 1811542699

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated June 03, 2025

Record deactivated on June 03, 2025

NPI Profile Active December 17, 2024

NPI status registered as active in NPPES database

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Updated Practice Location December 17, 2024

Registered at 3550 NORTHFIELD RD, SHAKER HEIGHTS, OH 441225253 (Tel: 2167525600)

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Updated Business Mailing Address December 17, 2024

Registered at 16016 WESTVIEW AVE, CLEVELAND, OH 441282132 (Tel: 2168549427)

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Provider Name / Credentials Updated December 17, 2024

Recorded as MILDRED TRAMMELL DEVONTENNO, NURSE

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Medical Taxonomy / Specialty Registered (Primary Specialty) December 17, 2024

Licensed Practical Nurse (License #151367 in OH)

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Initial NPI Registration & Enumeration December 17, 2024

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1205643640
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 17, 2024
Last Update: December 17, 2024
Deactivation Date: June 03, 2025

Mailing Address

16016 Westview Ave

Cleveland, OH 441282132

Phone: 2168549427

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.