Angela Kaye Deyong

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN9300931 Issued in FL

Practice address

36468 Emerald Coast Pkwy Ste 7102
Destin, FL 32541-0712

Phone

(850) 842-3256

Fax

(850) 353-2561

NPI assigned

Jul 18, 2013

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1374105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1326480344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36468 EMERALD COAST PKWY STE 7102",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325410712",
            "telephone_number": "850-842-3256",
            "fax_number": "850-353-2561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36468 EMERALD COAST PKWY STE 7102",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325410712",
            "telephone_number": "850-842-3256",
            "fax_number": "850-353-2561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEYONG",
        "first_name": "ANGELA",
        "middle_name": "KAYE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-18",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9300931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013431500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSFL",
            "identifier": "Y0P4Q",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Destin Surgery Center LLC
• Destin Surgery Clinic, P.a.
• Destin Vein Center LLC
• Destination Little Learners ABA Services, LLC
• Destiny Support Coordinators, Inc
• Diabetes and Endocrine Clinic PLLC
• Gerardo J Dieguez Gomez, M.D.
• Doctors Direct LLC
• Nicholas Paul Dotta, PHARM.D.
• Hannah Lianne Douglas, COTA

• Family Nurse Practitioner in Destin, FL
• Providers in Destin, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.