Liberty Woodruff Deegan, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA059699 Issued in PA

Practice address

16 Woodbine Lane
Danville, PA 17822-9800

Phone

(570) 271-6700

Fax

(570) 214-6700

NPI assigned

Feb 9, 2018

Last updated

Aug 31, 2020By 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 1

Addresses

Electronic endpoints 1

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

Physician Assistant

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

{
    "created_epoch": "1518134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598832000000",
    "number": "1164921631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 WOODBINE LANE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178229800",
            "telephone_number": "570-271-6700",
            "fax_number": "570-214-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEEGAN",
        "first_name": "LIBERTY",
        "middle_name": "WOODRUFF",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-09",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA059699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ldeegan161198@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "16 Woodbine Lane",
            "city": "Danville",
            "state": "PA",
            "country_code": "US",
            "postal_code": "178229800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Maria Debellis, RPH
• Debra H. Cole, PH.D.
• David Decoskey, D.O.
• Brian Deegan
• John Deegan, D.O.
• Morgan K Deegan, OTR/L, CHT
• Myla Deganich, DO
• Bhargavi Degapudi, MD
• Kathryn Ann Dehart, M.D.
• Amir R. Dehdashti, M.D.

• Physician Assistant in Danville, PA
• Providers in Danville, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2020; 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.