Kayleigh Davis Defoore, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0010-04256 Issued in NC

Practice address

1717 W Cowles St
Fairbanks, AK 99701-5926

Phone

(907) 451-6682

NPI assigned

May 29, 2013

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: kayleigh.defoore.1@15989.direct.athenahealth.com

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

{
    "created_epoch": "1369785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618444800000",
    "number": "1528405602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94429",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981246729",
            "telephone_number": "907-451-6682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 W COWLES ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997015926",
            "telephone_number": "907-451-6682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFOORE",
        "first_name": "KAYLEIGH",
        "middle_name": "DAVIS",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-29",
        "last_updated": "2021-04-15",
        "certification_date": "2021-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-04256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samuel Deblauw, PHYSICIAN ASSISTANT
• Thomas Deblauw, PA-C
• Jeanne Bamrick Debono, MD
• Elizabeth Easley Decker, PA-C
• Amy Decorso
• Porsche Dehut, APRN
• Joseph R Deitz, M.D.
• Caralyne Delaney, N.D.
• Dorothy S Delaney, ANP
• Brandon Evan Delkittie

• Medical Physician Assistant in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Medical Physician Assistant in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2021; 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.