Individual provider Active NPI

Deanna Michelle Gideons Lalama, PA-C

  • Physician Assistant
  • Greensboro, NC
National Provider Identifier
1528007259
Registry record updated Jan 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1066734 Issued in NC
Practice address
2835 Horse Pen Creek Rd Ste 101
Greensboro, NC 27410
Phone
(336) 617-6568
Fax
(336) 617-6660
NPI assigned
Jun 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1066734 NC Primary
Medical Physician Assistant 363AM0700X 1066734 NC

Addresses

Primary practice location

2835 Horse Pen Creek Rd Ste 101
Greensboro, NC 27410

Mailing address

2835 Horse Pen Creek Rd Ste 101
Greensboro, NC 27410-9700
Phone (336) 617-6568

Other identifiers 1

IdentifierTypeStateIssuer
561274347OtherNCCKA'S TAX ID #

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050801001031 NC Practitioner - Physician Assistant 8820026768 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greensboro Rheumatology PAGroup PAC ID 6406147768, 4 clinicians

Practice addresses (Care Compare)

2835 Horse Pen Creek Rd
Suite 101
Greensboro, NC 27410-9700
Phone (336) 617-6568

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1066734NCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Alamance Regional Medical Center, Inc CurrentSince Nov 2, 2020 Accepting new patients
The Moses H Cone Memorial Hospital Operating Corporation Physician Assistant CurrentSince Jun 9, 2014 Accepting new patients
The Moses H Cone Memorial Hospital Operating Corporation CurrentSince Jun 9, 2014 Accepting new patients

Locations

1248 Huffman Mill Rd
Ste 104
Burlington, NC 27215
Phone (336) 278-9011

1240 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 538-7000

1131 N Church St
Greensboro, NC 27401
Phone (336) 358-5100

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1528007259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2835 HORSE PEN CREEK RD STE 101",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274109700",
            "telephone_number": "336-617-6568",
            "fax_number": "336-617-6660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2835 HORSE PEN CREEK RD STE 101",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "27410",
            "telephone_number": "336-617-6568",
            "fax_number": "336-617-6660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LALAMA",
        "first_name": "DEANNA MICHELLE",
        "middle_name": "GIDEONS",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2024-01-12",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "1066734",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "1066734",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CKA'S TAX ID #",
            "identifier": "561274347",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.