Individual provider Active NPI

Deshana A. Collett, PA-C

  • Physician Assistant
  • Lexington, KY
National Provider Identifier
1336233998
Registry record updated Jan 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA845 Issued in KY
Practice address
989 Governors LN Ste 240
Lexington, KY 40513-1175
Phone
(859) 338-3958
Fax
(859) 368-8135
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA845 KY
Physician Assistant 363A00000X PA845 KY Primary

Addresses

Primary practice location

989 Governors LN Ste 240
Lexington, KY 40513-1175

Mailing address

989 Governors LN Ste 240
Lexington, KY 40513-1175
Phone (859) 338-3958

Other identifiers 1

IdentifierTypeStateIssuer
95004800MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20040719000159 KY Practitioner - Physician Assistant 3375522873 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bluegrass Extended Care Services LLCGroup PAC ID 4688832090, 7 clinicians

Practice addresses (Care Compare)

989 Governors LN
Suite 240
Lexington, KY 40513-1175
Phone (859) 338-3958

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

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.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768262400000",
    "number": "1336233998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "989 GOVERNORS LN STE 240",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405131175",
            "telephone_number": "859-338-3958",
            "fax_number": "859-368-8135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "989 GOVERNORS LN STE 240",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405131175",
            "telephone_number": "859-338-3958",
            "fax_number": "859-368-8135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLETT",
        "first_name": "DESHANA",
        "middle_name": "A.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2026-01-13",
        "certification_date": "2026-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KY",
            "license": "PA845",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA845",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95004800",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.