Individual provider Active NPI

Kitson Tevin Mitchell Jr Deane, MD

  • Gastroenterology Physician
  • Wilson, NC
National Provider Identifier
1487215109
Registry record updated Feb 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
2025-00834 Issued in NC
Practice address
1705 Tarboro St SW
Wilson, NC 27893-3437
Phone
(252) 399-8040
NPI assigned
Jun 24, 2019
Last updated
Feb 11, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Gastroenterology Physician 207RG0100X 2025-00834 NC Primary

Addresses

Primary practice location

1705 Tarboro St SW
Wilson, NC 27893-3437

Mailing address

1705 Tarboro St SW
Wilson, NC 27893-3437
Phone (252) 399-8040

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250818002042 NC Practitioner - Internal Medicine 2860991718 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1700 Tarboro W St
Suite 205
Wilson, NC 27893-3481
Phone (252) 399-5304

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy13
Upper gastrointestinal (GI) endoscopy for acid reflux15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2025-00834NCMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Wilson Physician Practices LLC CurrentSince Jul 1, 2025 Accepting new patients
DLP Wilson Physician Practices LLC Internal Medicine Current Accepting new patients
DLP Wilson Physician Practices LLC CurrentSince Jul 1, 2025 Accepting new patients

Locations

1700 Tarboro St W
Ste 205
Wilson, NC 27893
Phone (252) 399-5304

1705 Tarboro St SW
Wilson, NC 27893
Phone (252) 399-8040

2605 Forest Hills Rd SW
Ste A
Wilson, NC 27893
Phone (252) 243-0043

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

Interoperability endpoints

  • Direct secure messaging: kitson.deane.1@9600.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1561334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770768000000",
    "number": "1487215109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 TARBORO ST SW",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278933437",
            "telephone_number": "252-399-8040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 TARBORO ST SW",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278933437",
            "telephone_number": "252-399-8040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEANE",
        "first_name": "KITSON",
        "middle_name": "TEVIN MITCHELL JR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-24",
        "last_updated": "2026-02-11",
        "certification_date": "2026-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NC",
            "license": "2025-00834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilson, NC

Sources for this page

Verify at the official NPI Registry.