Kenneth D Deaton Jr., M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

31585 Issued in GA

Practice address

800 1St St
Suite 410
Macon, GA 31201-8300

Phone

(478) 743-7068

Fax

(478) 741-1354

NPI assigned

Jun 16, 2006

Last updated

Dec 22, 2014By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: kenneth.deaton.1@14077.direct.athenahealth.com

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.

• Bioserenity USA Inc.

  dba Pivotal Health

  • Sleep Disorder Diagnostic Clinic/Center
  • Baltimore, MD
  • NPI 1457992604
  NPD (past)

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419206400000",
    "number": "1124062187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 1ST ST",
            "address_2": "SUITE 410",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312018300",
            "telephone_number": "478-743-7068",
            "fax_number": "478-741-1354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 1ST ST",
            "address_2": "SUITE 410",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312018300",
            "telephone_number": "478-743-7068",
            "fax_number": "478-741-1354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEATON",
        "first_name": "KENNETH",
        "middle_name": "D",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2014-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "31585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000385019E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Davey R Deal Jr., M.D.
• Morgan Ashlynn Dean, MA, LPC, NCC
• Robert Jonathan Dean, M.D
• Sharral M. Dean, LPC
• Shelter Dean
• Susan Meredith Debey, NP-C
• Elijah Debroux, MD
• Laura Shirlene Decker, APRN
• Gregory M Deedrick, PA-AA
• Karen U Deen, RPH

• Specialist in Macon, GA
• Providers in Macon, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.