Natalie Wynn Deal, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9503 Issued in GA

Practice address

4321 University Pkwy Ste 104
Evans, GA 30809-3093

Phone

(706) 854-2600

NPI assigned

Oct 15, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Natalie Ryan Wynn 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": "1571097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1467094052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4321 UNIVERSITY PKWY STE 104",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093093",
            "telephone_number": "706-854-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4321 UNIVERSITY PKWY STE 104",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093093",
            "telephone_number": "706-854-2600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "902 Ponder Place Ct",
            "address_purpose": "LOCATION",
            "city": "Evans",
            "state": "GA",
            "postal_code": "308093115",
            "country_code": "US",
            "telephone_number": "706-364-3223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEAL",
        "first_name": "NATALIE",
        "middle_name": "WYNN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-15",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "9502",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "9503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NATALIE",
            "last_name": "WYNN",
            "middle_name": "RYAN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Adrienne Cole Davis, PHD
• Christopher Davis
• James Barry Davis, M.D.
• Martinique Davis, RBT
• Lindsay Wallace Day, PA
• Robert Tyson Deal, MD
• Nicholas A. Deangelo, D.O.
• Debbie R. Johnson, LPC LLC
• Karen P Decario-Webber, PT
• Roger S. Delappe Jr., M.D.

• Physician Assistant in Evans, GA
• Providers in Evans, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2022; 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.