Active NPI
Paul Edward Deshane, PTA
- Physical Therapy Assistant
- East Ellijay, GA
National Provider Identifier
1538099346
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA002769
- Practice address
- 97 Hefner St Ste 100
East Ellijay, GA 30540-8268 - Phone
- (706) 635-1440
- NPI assigned
- May 22, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA002769 | GA | Primary |
Addresses
Primary practice location
97 Hefner St Ste 100
East Ellijay, GA 30540-8268
Mailing address
390 Laiken Dr
Jasper, GA 30143-8362
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA002769 | GA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1779408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779408000000",
"number": "1538099346",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "390 LAIKEN DR",
"city": "JASPER",
"state": "GA",
"postal_code": "301438362"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "97 HEFNER ST STE 100",
"city": "EAST ELLIJAY",
"state": "GA",
"postal_code": "305408268",
"telephone_number": "706-635-1440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESHANE",
"first_name": "PAUL",
"middle_name": "EDWARD",
"name_prefix": "Mr.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-05-22",
"last_updated": "2026-05-22",
"certification_date": "2026-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "GA",
"license": "PTA002769",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Ellijay, GA
- Bonnie G Bradley, OD
- Brittney Nicole Byars, FNP-C
- Cardiac Disease Specialists, PC
- Cardiovascular Imaging of North Georgia LLC
- John Walsh Davis, D.C.
- Digestive Healthcare of Ga, P.C.
- Jan Wood Dowda, RPH
- Ellijay Urgent Care & Family Practice LLC
- Islam G Eltarawy, MD
- Envision a Chiropractic Healing, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.