Individual provider Active NPI

Deanna Lynn Markley, PA

  • Medical Physician Assistant
  • Reston, VA
National Provider Identifier
1821279381
Registry record updated Mar 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0110840512 Issued in VA
Practice address
12040 S Lakes Dr
Suite 207
Reston, VA 20191-1246
Phone
(703) 464-0686
Fax
(703) 703-6406
NPI assigned
Nov 26, 2007
Last updated
Mar 27, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0110840512 VA Primary

Addresses

Primary practice location

12040 S Lakes Dr
Suite 207
Reston, VA 20191-1246

Mailing address

12040 S Lakes Dr
Suite 207
Reston, VA 20191-1246
Phone (703) 464-0686

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20141229001711 VA Practitioner - Physician Assistant 8123248804 Reassigns benefits to 1 organization

National Provider Directory

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

Organizations & group practices 1

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": "1196035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427414400000",
    "number": "1821279381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12040 S LAKES DR",
            "address_2": "SUITE 207",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201911246",
            "telephone_number": "703-464-0686",
            "fax_number": "703-464-0698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12040 S LAKES DR",
            "address_2": "SUITE 207",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201911246",
            "telephone_number": "703-464-0686",
            "fax_number": "703-703-6406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKLEY",
        "first_name": "DEANNA",
        "middle_name": "LYNN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-26",
        "last_updated": "2015-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110840512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reston, VA

Sources for this page

Verify at the official NPI Registry.