William Deferia, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

022537 Issued in GA

Practice address

620 Broad St
Central State Hospital
Milledgeville, GA 31062-7525

Phone

(478) 445-4128

NPI assigned

Aug 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Department of Behavioral Health and Developmental Disabilities

  • Psychiatric Hospital
  • Milledgeville, GA
  • NPI 1902030307
  Medicare reassignment NPD
• Department of Behavioral Health & Developmental Disabilities, Ga

  • Neurology Physician
  • Thomasville, GA
  • NPI 1174942684

  General Practice

  NPD

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841202769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 BROAD ST",
            "address_2": "CENTRAL STATE HOSPITAL",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310627525",
            "telephone_number": "478-445-4128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 BROAD ST",
            "address_2": "CENTRAL STATE HOSPITAL",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310627525",
            "telephone_number": "478-445-4128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFERIA",
        "first_name": "WILLIAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "GA",
            "license": "022537",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00593381A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Margaret Elizabeth Davis
• Keyanna Bresha Dawson
• Patricia Dedrick, ATC, LAT
• Raymond William Deen, DO
• Roy Wendell Deen, M.D.
• Alisa Parham Dennis, ALISA DENNIS
• David Keith Dent, RPH
• Department of Behavioral Health and Developmental Disabilities
• Department of Behavioral Health and Developmental Disabilities
• Tarmesha Devereaux

• General Practice Physician in Milledgeville, GA
• Providers in Milledgeville, GA by specialty
• General Practice Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.