Mary Katelynn Debacher, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2024 Issued in KY

Practice address

1225 S Broadway Ste 201
Lexington, KY 40504

Phone

(859) 258-4568

Fax

(859) 258-4698

NPI assigned

Sep 17, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mary Katelynn Hardin Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1442448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533254400000",
    "number": "1457720724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 S BROADWAY STE 201",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405042701",
            "telephone_number": "859-258-4568",
            "fax_number": "859-258-4698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 S BROADWAY STE 201",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "40504",
            "telephone_number": "859-258-4568",
            "fax_number": "859-258-4698"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 Saint Marys Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Evansville",
            "state": "IN",
            "postal_code": "477140509",
            "country_code": "US",
            "telephone_number": "812-485-6030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEBACHER",
        "first_name": "MARY",
        "middle_name": "KATELYNN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-17",
        "last_updated": "2018-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10002217A",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA2024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "HARDIN",
            "middle_name": "KATELYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Angela Tackett Dearinger, MD
• Elizabeth Ann Deaton
• McKenna Brooke Deaton
• Sarah Helen Deaton
• Stephen Paul Deaton, LPO
• Frederick Coenraad Debeer, MD
• Miles Deberge
• John Debilzan, ATC
• Deborah Goad, LMFT
• Deborah K Phillips Mdpa

• Physician Assistant in Lexington, KY
• Providers in Lexington, KY by specialty
• Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2018; 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.