Individual provider Active NPI

Destiny Kate Dean, CRNP

  • Family Nurse Practitioner
  • Montgomery, AL
National Provider Identifier
1194342469
Registry record updated Sep 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-148388 Issued in AL
Practice address
2055 E South Blvd Ste 503
Montgomery, AL 36116-2004
Phone
(334) 284-6500
NPI assigned
Jul 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-148388 AL Primary

Addresses

Primary practice location

2055 E South Blvd Ste 503
Montgomery, AL 36116-2004

Mailing address

2055 E South Blvd Ste 503
Montgomery, AL 36116-2004
Phone (334) 284-6500

Other practice location 1

277 Huntress St Ste 201
Wetumpka, AL 36092-3342
Phone (334) 284-6500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20201020003543 AL Practitioner - Nurse Practitioner 0547680126 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Montgomery Vascular Surgery, P.C.Group PAC ID 0840210530, 7 clinicians

Practice addresses (Care Compare)

2055 E S Blvd
Suite 503
Montgomery, AL 36116-2004
Phone (334) 284-6500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
74.33 of 100Reported as group
Quality
39.07
Improvement activities
40
Cost
73.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1-148388ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Montgomery Vascular Surgery, P.C. CurrentSince Sep 1, 2020 Accepting new patients

Locations

2055 E South Blvd
Ste 908
Montgomery, AL 36116
Phone (334) 284-6500

2055 E South Blvd
Ste 503
Montgomery, AL 36116
Phone (205) 284-6500

277 Huntress St
Ste 201
Wetumpka, AL 36092
Phone (334) 284-6500

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": "1593648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1194342469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 E SOUTH BLVD STE 503",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361162004",
            "telephone_number": "334-284-6500",
            "fax_number": "334-284-6202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 E SOUTH BLVD STE 503",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361162004",
            "telephone_number": "334-284-6500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "277 Huntress St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Wetumpka",
            "state": "AL",
            "postal_code": "360923342",
            "country_code": "US",
            "telephone_number": "334-284-6500",
            "fax_number": "334-284-6202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEAN",
        "first_name": "DESTINY",
        "middle_name": "KATE",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-02",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-148388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.