Individual provider Active NPI

Akacyea Nycole Deck, PA-C

  • Physician Assistant
  • Jackson, TN
National Provider Identifier
1124615497
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4647 Issued in TN
Practice address
145 Innovation Dr
Jackson, TN 38305-3019
Phone
(731) 422-0213
Fax
(731) 422-0297
NPI assigned
Dec 21, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4647 TN Primary

Addresses

Primary practice location

145 Innovation Dr
Jackson, TN 38305-3019

Mailing address

PO Box 400
Jackson, TN 38302-0400
Phone (731) 423-8697

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20210819001552 TN Practitioner - Physician Assistant 7911302591 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jackson Clinic PAGroup PAC ID 2668376872, 171 clinicians

Practice addresses (Care Compare)

145 Innovation Dr
Jackson, TN 38305-3019
Phone (731) 422-0213

2859 Hwy 45 Byp
Jackson, TN 38305-3618
Phone (731) 664-1375

2863 Hwy 45 Byp
Jackson, TN 38305-3618
Phone (731) 664-1375

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.15 of 100Reported as group
Quality
74.15
Promoting interoperability
77
Improvement activities
40
Cost
78.84

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4647TNMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Clinic PA CurrentSince Aug 1, 2024 Accepting new patients

Locations

87 Murray Guard Dr
Ste B
Jackson, TN 38305
Phone (731) 664-1375

620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923

619 Skyline Dr
Jackson, TN 38301
Phone (731) 424-3682

145 Innovation Dr
Jackson, TN 38305

Interoperability endpoints

  • Direct secure messaging: akacyeadeck@jcpa.allscriptsdirect.net

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1608508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1124615497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 400",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383020400",
            "telephone_number": "731-423-8697",
            "fax_number": "731-425-5783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 INNOVATION DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053019",
            "telephone_number": "731-422-0213",
            "fax_number": "731-422-0297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECK",
        "first_name": "AKACYEA",
        "middle_name": "NYCOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-21",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "4647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.