Individual provider Active NPI

Kristin F Deutsch, N.P.

  • Family Nurse Practitioner
  • Thomasville, GA
National Provider Identifier
1043215924
Registry record updated Sep 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN123631 NP Issued in GA
Practice address
112 Mimosa Dr
Thomasville, GA 31792-6605
Phone
(229) 227-0045
Fax
(229) 227-9120
NPI assigned
Jun 16, 2005
Last updated
Sep 18, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN123631 NP GA Primary

Addresses

Primary practice location

112 Mimosa Dr
Thomasville, GA 31792-6605

Mailing address

900 Cairo Rd
Thomasville, GA 31792-4255

Other identifiers 1

IdentifierTypeStateIssuer
510449296AMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kristin.deutsch.p26@direct.archbold.nextgenshare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041006000541 GA Practitioner - Nurse Practitioner 8325007362 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Archbold Medical Group, Inc.Group PAC ID 8123196383, 80 clinicians

Practice addresses (Care Compare)

100 Mimosa Dr
Thomasville, GA 31792-6676
Phone (229) 228-5500

112 Mimosa Dr
Thomasville, GA 31792-6605
Phone (229) 227-0045

116 Mimosa Dr
Suite 2
Thomasville, GA 31792-6605
Phone (229) 228-5500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN123631 NPGAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Archbold Medical Group CurrentSince Nov 1, 2015 Accepting new patients
Archbold Medical Group, Inc. Current Accepting new patients
Archbold Medical Group, Inc. CurrentSince Nov 1, 2015 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

100 Mimosa Dr
Thomasville, GA 31792
Phone (229) 226-9141

112 Mimosa Dr
Thomasville, GA 31792
Phone (229) 227-0045

900 Cairo Rd
Thomasville, GA 31792
Phone (229) 227-5102

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600387200000",
    "number": "1043215924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 CAIRO RD",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317924255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 MIMOSA DR",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317926605",
            "telephone_number": "229-227-0045",
            "fax_number": "229-227-9120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEUTSCH",
        "first_name": "KRISTIN",
        "middle_name": "F",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-16",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN123631 NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "510449296A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kristin.deutsch.p26@direct.archbold.nextgenshare.com",
            "affiliation": "N",
            "address_1": "112 Mimosa Dr",
            "city": "Thomasville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "317926605",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Thomasville, GA

Sources for this page

Verify at the official NPI Registry.