Michael Wayne Deeds, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA03575 Issued in TX

Practice address

18780 Interstate 20
Canton, TX 75103-3593

Phone

(903) 567-4841

NPI assigned

Jul 28, 2005

Last updated

Mar 11, 2015By 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 3

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mdeeds3696@christushealth.direct-ci.net

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.

• Family Practice Associates of Ulysses LLC

  • Family Medicine Physician
  • Ulysses, KS
  • NPI 1316916638
  NPD (past)

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426032000000",
    "number": "1396745758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 846098",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752846098",
            "telephone_number": "903-324-6450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18780 INTERSTATE 20",
            "city": "CANTON",
            "state": "TX",
            "postal_code": "751033593",
            "telephone_number": "903-567-4841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEEDS",
        "first_name": "MICHAEL",
        "middle_name": "WAYNE",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2015-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "1500540",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "10117",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA03575",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8Y2333",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201289001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "8J89591YMAF",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100454690A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dailey Medical Clinic
• Dailey Medical Clinic
• Jimmy W Dailey, MD
• Dallas County Hospital District (Canton Oaks)
• Jonathan Charles David, D.O.
• Taylor Deen, CCC-SLP
• Chelsea Deleon, DC
• Debra D Dewart, OD PA
• Diverse Care Clinic of Canton PLLC
• Emily Ann Dosier, M.D.

• Physician Assistant in Canton, TX
• Providers in Canton, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.