Individual provider Active NPI

Roger Johannes Debeus, PH.D.

  • Psychologist
  • Asheville, NC
National Provider Identifier
1124033824
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY004752 Issued in GA
Practice address
14 S Pack SQ
Suite 350
Asheville, NC 28801-3511
Phone
(828) 333-5359
Fax
(828) 333-5359
NPI assigned
Jul 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 3306 NC
Clinical Psychologist 103TC0700X 0810002866 VA
Psychologist 103T00000X PSY004752 GA Primary

Addresses

Primary practice location

14 S Pack SQ
Suite 350
Asheville, NC 28801-3511

Mailing address

3196 Arches Bluff Cir
Lancaster, SC 29720-0156
Phone (828) 782-7628

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, GA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20091201000496 NC Practitioner - Clinical Psychologist 2062465958 Practice locations: Asheville, NC
I20240208003697 GA Practitioner - Clinical Psychologist 2062465958 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY004752GAMDPsychologist
3306NCMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Christopher Dennis MD PLLC Clinical CurrentSince Feb 16, 2024 Accepting new patients
Parker Schlichter & Associates Past Accepting new patients

Locations

1420 Milstead Rd NE
Conyers, GA 30012
Phone (770) 483-3902

11340 Lakefield Dr
Ste 200
Johns Creek, GA 30097
Phone (678) 407-2159

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1124033824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3196 ARCHES BLUFF CIR",
            "city": "LANCASTER",
            "state": "SC",
            "postal_code": "297200156",
            "telephone_number": "828-782-7628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 S PACK SQ",
            "address_2": "SUITE 350",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288013511",
            "telephone_number": "828-333-5359",
            "fax_number": "828-333-5359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBEUS",
        "first_name": "ROGER",
        "middle_name": "JOHANNES",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-30",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "3306",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810002866",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY004752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Asheville, NC

Sources for this page

Verify at the official NPI Registry.