Vicki R Deweese, FNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN145900 Issued in GA

Practice address

475 Reed Rd Ste 104
Dalton, GA 30720-6307

Phone

(706) 529-8710

Fax

(706) 529-8715

NPI assigned

Oct 18, 2005

Last updated

Jan 24, 2024By 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 1

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, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Agape Youth Behavioral HealthGroup PAC ID 1254731417, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Agape Youth Behavioral Health

  • Child & Adolescent Psychiatry Physician
  • Chattanooga, TN
  • NPI 1528405925

  GA

  Medicare reassignment Care Compare group NPD
• Hamilton Medical Center, Inc.

  • General Acute Care Hospital
  • Dalton, GA
  • NPI 1528056066
  NPD
• Dalton Cardiology, P.C.

  • Cardiovascular Disease Physician
  • Dalton, GA
  • NPI 1669491619
  NPD (past)

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1164411559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 REED RD STE 104",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307206307",
            "telephone_number": "706-529-8710",
            "fax_number": "706-529-8715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 REED RD STE 104",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307206307",
            "telephone_number": "706-529-8710",
            "fax_number": "706-529-8715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWEESE",
        "first_name": "VICKI",
        "middle_name": "R",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-18",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN145900",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "6358",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000848658",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dental One Associates (Dalton) LLC
• Danielle Darlene Deretchin, ATC
• Daniel Dereuter, D.C.
• Asia Karenina Deslattes, NP-C
• Kristen Payne Deweese, DO
• Anushka Dhabuwala
• Gretchen Diaz-Lopez, M.D.
• Anna Lee Dickson, PA
• Kathryn Chloe Dickson, PTA
• Sharon W Dickson, LPC

• Nurse Practitioner in Dalton, GA
• Providers in Dalton, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2024; 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.