Calvin Edward Defenbau IV, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN-NP209756 Issued in GA

Practice address

725 Jesse Jewell Pkwy SE
Gainesville, GA 30501-3834

Phone

(678) 207-4373

Fax

(770) 533-4727

NPI assigned

Jun 30, 2018

Last updated

Oct 30, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

The Longstreet Clinic, PCGroup PAC ID 2668465733, 140 clinicians

Northeast Georgia Community Physicians LLCGroup PAC ID 3274010582, 129 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northeast Georgia Medical Center, Inc Hospital, Gainesville, GA, CCN 110029

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.

• Northeast Georgia Community Physicians LLC

  dba Longstreet of NGHS

  • Internal Medicine Physician
  • Gainesville, GA
  • NPI 1881583730
  Medicare reassignment Care Compare group NPD
• The Longstreet Clinic, PC

  • Internal Medicine Physician
  • Gainesville, GA
  • NPI 1326019977
  Medicare reassignment Care Compare group NPD
• Careconnect Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Richland, GA
  • NPI 1063436624
  Medicare reassignment NPD
• Careconnect Health, Inc.

  dba CareConnect Convenient Care

  • Federally Qualified Health Center (FQHC)
  • Sylvester, GA
  • NPI 1811874696
  NPD
• The Longstreet Clinic PC

  • Prosthetic/Orthotic Supplier
  • Gainesville, GA
  • NPI 1053422428
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Northeast Georgia Medical Center, Inc.

  • General Acute Care Hospital
  • Gainesville, GA
  • NPI 1427055821
  Care Compare affiliation

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

{
    "created_epoch": "1530316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1265927362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 658",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305030658",
            "telephone_number": "770-718-1122",
            "fax_number": "770-533-4786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 JESSE JEWELL PKWY SE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013834",
            "telephone_number": "678-207-4373",
            "fax_number": "770-533-4727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "122 Shirley Rd",
            "address_purpose": "LOCATION",
            "city": "Americus",
            "state": "GA",
            "postal_code": "31709",
            "country_code": "US",
            "telephone_number": "229-942-9043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEFENBAU",
        "first_name": "CALVIN",
        "middle_name": "EDWARD",
        "name_suffix": "IV",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-30",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "APRN-NP209756",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN209756",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Danielle Deberry, NNP-BC
• Stephanie Ann Debski, NNP-BC
• Barry Edward Decarlo, PHARM D.
• Kendall Marie Decino, AA
• Julie Decker
• Deanna Steele Defoor, AGPCNP
• Felipe Miguel Del Rosario Martinez, B.S. D.C.
• Yesenia Delosangeles, LCSW
• Delta Ambulance LLC
• John E Delzell Jr., M.D.

• Family Nurse Practitioner in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2025; 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.