Deepa Nayak, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2011-01407 Issued in NC

Practice address

1236 Guilford College Road
Suite 117
Jamestown, NC 27282-9875

Phone

(336) 299-3161

Fax

(336) 299-3180

NPI assigned

Jul 7, 2008

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 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dnayak22262@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 NPD
• Novant Health Medical Group LLC

  dba NHMG Pediatric Clinics

  • Pediatrics Physician
  • Charlotte, NC
  • NPI 1922721141
  NPD
• Novant Health Medical Group, LLC

  dba Novant Health Elizabeth OB/GYN

  • Obstetrics & Gynecology Physician
  • Matthews, NC
  • NPI 1386506137
  NPD
• Novant Health Medical Group, LLC

  dba Novant Health Northlake Dermatology

  • Dermatopathology Physician
  • Huntersville, NC
  • NPI 1396751640
  NPD (past)

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

{
    "created_epoch": "1215388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640217600000",
    "number": "1427211762",
    "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": "1236 GUILFORD COLLEGE ROAD",
            "address_2": "SUITE 117",
            "city": "JAMESTOWN",
            "state": "NC",
            "postal_code": "272829875",
            "telephone_number": "336-299-3161",
            "fax_number": "336-299-3180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2205 Oak Ridge Rd Ste Bb",
            "address_purpose": "LOCATION",
            "city": "Oak Ridge",
            "state": "NC",
            "postal_code": "273108645",
            "country_code": "US",
            "telephone_number": "336-644-0994",
            "fax_number": "336-644-0997",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAYAK",
        "first_name": "DEEPA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-07",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2011-01407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5919340",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dnayak22262@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "1236 Guilford College Road",
            "address_2": "Suite 117",
            "city": "Jamestown",
            "state": "NC",
            "country_code": "US",
            "postal_code": "272829875",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Travis Morgan
• Multi-Therapeutic Services, Inc.
• Samantha Ann Murrill Williams, NP
• Tiffany Muse, DNP AGNP
• Abigail Elizabeth Muurisepp, ATC
• Ronald Neal
• Michael Qui Nguyen
• North Carolina CVS Pharmacy LLC (CVS Pharmacy #03711)
• Novant Health Medical Group, LLC (Novant Health Parkside Family Medicine)
• Dirk Nuttle, LPCA, LCAS-A, CRC

• Pediatrics Physician in Jamestown, NC
• Providers in Jamestown, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2021; 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.