Andrea M Deloach, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN072616 Issued in GA

Practice address

711 Knight Ave
Waycross, GA 31501-1943

Phone

(912) 283-9423

Fax

(912) 283-2946

NPI assigned

Oct 16, 2006

Last updated

Jun 11, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

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

Specialty

Nurse Practitioner

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Internal Medicine Associates of Waycross P.C.Group PAC ID 0749276004, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Satilla Health Hospital, Waycross, GA, CCN 110003
• Bacon County Hospital Hospital, Alma, GA, CCN 111327

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: andrea.deloach@gwim.eclinicaldirectplus.com
• FHIR API: https://fhir4.healow.com/fhir/r4/CAJEAD/Endpoint/CAJEAD

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.

• Internal Medicine Associates of Waycross, P.C.

  dba Waycross Internal Medicine

  • Internal Medicine Physician
  • Waycross, GA
  • NPI 1144420530
  Medicare reassignment Care Compare group

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

• Bacon County Health Services, Inc.

  • Critical Access Hospital
  • Alma, GA
  • NPI 1629185285
  Care Compare affiliation
• Southeast Georgia Health Services, L.L.C.

  dba Memorial Satilla Health

  • Rural Acute Care Hospital
  • Waycross, GA
  • NPI 1922530468
  Care Compare affiliation

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623369600000",
    "number": "1114007044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 KNIGHT AVE",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315011943",
            "telephone_number": "912-283-9423",
            "fax_number": "912-283-2946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 KNIGHT AVE",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315011943",
            "telephone_number": "912-283-9423",
            "fax_number": "912-283-2946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELOACH",
        "first_name": "ANDREA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN072616",
            "primary": true
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "GA",
            "license": "RN072616",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP ID",
            "identifier": "CG6045",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00560381B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NPI",
            "identifier": "1114007044",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Boyce Dawson, PHARM. D
• Dean E. Thornton, DC, PC (Thornton Family Chiropractic)
• Ashley Minchew Deen
• Earnie Mae Deen, RN
• Oscar Jones Dell Jr., DC
• Guensley Ralph Delva, M.D.
• Robin Kay Denison, LPN
• Trishla Amit Desai, M.D.
• Diabetes & Endocrine Treatment Center
• Diabetes and Endocrine Treatment Center Inc. (Diabetes and Endocrine Treatment Center)

• Family Nurse Practitioner in Waycross, GA
• Providers in Waycross, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.