Active NPI
Donell Dawn Deremer, PA-C
- Physician Assistant
- Westminster, MD
National Provider Identifier
1205944634
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- C0001579
- Practice address
- 902 Washington Rd
Suite E
Westminster, MD 21157-5832 - Phone
- (410) 876-0286
- Fax
- (410) 876-0634
- NPI assigned
- Aug 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | C0001579 | MD | Primary |
Addresses
Primary practice location
902 Washington Rd
Suite E
Westminster, MD 21157-5832
Mailing address
629 Beaver Ruin Rd NW
Suite B
Lilburn, GA 30047-3468
Phone (770) 921-4300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C0001579 | MD | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Csi Medical Group | Past | Accepting new patients |
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1411430400000",
"number": "1205944634",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "629 BEAVER RUIN RD NW",
"address_2": "SUITE B",
"city": "LILBURN",
"state": "GA",
"postal_code": "300473468",
"telephone_number": "770-921-4300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "902 WASHINGTON RD",
"address_2": "SUITE E",
"city": "WESTMINSTER",
"state": "MD",
"postal_code": "211575832",
"telephone_number": "410-876-0286",
"fax_number": "410-876-0634"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEREMER",
"first_name": "DONELL",
"middle_name": "DAWN",
"name_prefix": "Ms.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-27",
"last_updated": "2014-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MD",
"license": "C0001579",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Westminster, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.