Terry Michael Deakle, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

00543 Issued in NC

Practice address

6301 Stadium Dr
Clemmons, NC 27012-8766

Phone

(336) 766-6473

Fax

(336) 766-8909

NPI assigned

Jan 18, 2006

Last updated

Jun 10, 2024By 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 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Physician Assistant

Education

Other, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Medi Home Health & Hospice Home health agency, Thomasville, NC, CCN 347185
• Novant Health Forsyth Medical Center Hospital, Winston-Salem, NC, CCN 340014

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tdeakle4874@direct.novanthealth.org

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.

• Novant Health Medical Group, LLC

  dba Novant Health Pediatric Neurology & Sleep

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment Care Compare group
• Novant Health Medical Group, LLC

  dba Novant Health Mountainview Medical Extended Care

  • Family Medicine Physician
  • King, NC
  • NPI 1245797745
  NPD
• Novant Health Medical Group, LLC

  dba Novant Health Elizabeth OB/GYN

  • Obstetrics & Gynecology Physician
  • Matthews, NC
  • NPI 1386506137
  NPD
• Novant Medical Group, Inc.

  dba Mid Carolina Cardiology

  • Interventional Cardiology Physician
  • Charlotte, NC
  • NPI 1205836434
  NPD (past)

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

• Forsyth Memorial Hospital, Inc.

  dba Novant Health Forsyth Medical Center

  • General Acute Care Hospital
  • Winston Salem, NC
  • NPI 1447200233
  Care Compare affiliation
• Medical Services of America, Inc.

  dba Medi Home Health Agency

  • Home Health Agency
  • Thomasville, NC
  • NPI 1336323526
  Care Compare affiliation

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1326028382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6301 STADIUM DR",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270128766",
            "telephone_number": "336-766-6473",
            "fax_number": "336-766-8909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAKLE",
        "first_name": "TERRY",
        "middle_name": "MICHAEL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "00543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tdeakle4874@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "6301 Stadium Dr",
            "address_2": "DBA Clemmons Family Practice",
            "city": "Clemmons",
            "state": "NC",
            "country_code": "US",
            "postal_code": "270128766",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• David Hong DMD PLLC
• Paul Kent Davis, PA-C
• Russell David Davis, PA
• Evie Cristina Davyromano, PHD, LMFT
• Mary Deakle, PA-C
• Joseph A Dealoe, RBT
• Martin Dekkers, DPT
• Lia Deland
• Robert Denig, LPC
• Todd Michael Derreberry, M.D.

• Physician Assistant in Clemmons, NC
• Providers in Clemmons, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.