NPIMap

Individual provider Active NPI

Carrie Dawn Deshong, PA

  • Physician Assistant
  • McConnellsburg, PA
National Provider Identifier
1619922358
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA051061 Issued in PA
Practice address
525 Fulton Drive
McConnellsburg, PA 17233
Phone
(717) 485-3850
Fax
(717) 485-3725
NPI assigned
May 23, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA051061 PA Primary

Addresses

Primary practice location

525 Fulton Drive
McConnellsburg, PA 17233

Mailing address

109 Rayloc Dr
Hancock, MD 21750-1518
Phone (301) 678-5187

Other identifiers 1

IdentifierTypeStateIssuer
MA051061OtherPAMEDICAL PHY ASST LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190813000014 PA Practitioner - Physician Assistant 9032370614 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

214 Peach Orchard Rd
MC Connellsburg, PA 17233-8559
Phone (717) 485-3155

525 Fulton Dr
MC Connellsburg, PA 17233-8061
Phone (717) 485-3850

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA051061PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-State Community Health Center, Inc CurrentSince Jun 16, 2019 Accepting new patients
Tri-State Community Health Center, Inc CurrentSince Jun 16, 2019 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

109 Rayloc Dr
Hancock, MD 21750
Phone (301) 678-5187

525 Fulton Dr
Mc Connellsburg, PA 17233
Phone (717) 485-3850

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 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1619922358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 RAYLOC DR",
            "city": "HANCOCK",
            "state": "MD",
            "postal_code": "217501518",
            "telephone_number": "301-678-5187",
            "fax_number": "301-678-5797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 FULTON DRIVE",
            "city": "MCCONNELLSBURG",
            "state": "PA",
            "postal_code": "17233",
            "telephone_number": "717-485-3850",
            "fax_number": "717-485-3725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESHONG",
        "first_name": "CARRIE",
        "middle_name": "DAWN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA051061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL PHY ASST LICENSE",
            "identifier": "MA051061",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McConnellsburg, PA

Sources for this page

Verify at the official NPI Registry.