Individual provider Active NPI

Heather Ruth Deibler, PA-C

  • Physician Assistant
  • Forest City, NC
National Provider Identifier
1720092042
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-05388 Issued in NC
Practice address
212 Allendale Dr
Forest City, NC 28043-2889
Phone
(828) 245-7626
NPI assigned
Jul 29, 2006
Last updated
Aug 19, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2022

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 9380 NY
Physician Assistant 363A00000X 0010-05388 NC Primary

Addresses

Primary practice location

212 Allendale Dr
Forest City, NC 28043-2889

Mailing address

212 Allendale Dr
Forest City, NC 28043-2889
Phone (828) 245-7626

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
I20170131000388 NC Practitioner - Physician Assistant 8921145731 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-05388NCMDPhysician Assistant
9380NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Rutherford Physician Practices LLC CurrentSince Nov 1, 2021 Accepting new patients
DLP Rutherford Physician Practices LLC CurrentSince Nov 1, 2021 Accepting new patients
DLP Rutherford Physician Practices LLC Physician Assistant Past Accepting new patients

Locations

801 W Mills St
Ste B
Columbus, NC 28722
Phone (828) 692-8097

1269 US Highway 221A
Forest City, NC 28043
Phone (828) 657-5371

212 Allendale Dr
Forest City, NC 28043
Phone (828) 245-3575

605 NC 120 Hwy
Mooresboro, NC 28114
Phone (828) 453-0703

288 S Ridgecrest Ave
Rutherfordton, NC 28139
Phone (252) 808-6000

Interoperability endpoints

  • Direct secure messaging: heather.deibler.1@20612.direct.athenahealth.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1720092042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 ALLENDALE DR",
            "city": "FOREST CITY",
            "state": "NC",
            "postal_code": "280432889",
            "telephone_number": "828-245-7626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 ALLENDALE DR",
            "city": "FOREST CITY",
            "state": "NC",
            "postal_code": "280432889",
            "telephone_number": "828-245-7626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEIBLER",
        "first_name": "HEATHER",
        "middle_name": "RUTH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-29",
        "last_updated": "2022-08-19",
        "certification_date": "2022-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "9380",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-05388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest City, NC

Sources for this page

Verify at the official NPI Registry.