Jack Melvin Deese Jr., M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

24534 Issued in GA

Practice address

3025 Shrine Rd
Suite 390
Brunswick, GA 31520-4784

Phone

(912) 466-7340

Fax

(912) 466-7358

NPI assigned

Aug 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Cooperative Healthcare Services Inc

  • Clinic/Center
  • Brunswick, GA
  • NPI 1417979402

  Orthopaedic Surgery

  NPD
• Applecare LLC

  • Urgent Care Clinic/Center
  • Statesboro, GA
  • NPI 1134559396
  NPD (past)
• Hospital Authority of the City of Bainbridge and Decatur County

  • Multi-Specialty Clinic/Center
  • Bainbridge, GA
  • NPI 1053388256
  NPD (past)

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451952000000",
    "number": "1124038856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3025 SHRINE RD",
            "address_2": "SUITE 390",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204784",
            "telephone_number": "912-466-7340",
            "fax_number": "912-466-7358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3025 SHRINE RD",
            "address_2": "SUITE 390",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204784",
            "telephone_number": "912-466-7340",
            "fax_number": "912-466-7358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEESE",
        "first_name": "JACK",
        "middle_name": "MELVIN",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2016-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "GA",
            "license": "24534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• M Elaine Day, RN
• Lourdes De Armas, M.D.
• Mary Kerle Deal, CCC/SLP
• Summer Mariah King Deason, OTRL
• Mahal Deck, WHNP-BC
• Cassandra Dehaney, LPC
• Shane Dehaven, D.C.
• Alisha Lynn Delgado, NBHWC
• Shayna Denham
• Denice Starley, DO, LLC

• All providers in Brunswick, GA
• Orthopaedic Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.