Luvey Deatherage, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2839 Issued in OK

Practice address

36640 Old Hwy 270
Wewoka, OK 74884

Phone

(405) 257-6282

NPI assigned

Jan 26, 2018

Last updated

Mar 4, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

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

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Immediate Care of Oklahoma LLCGroup PAC ID 2668540774, 34 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Immediate Care of Oklahoma LLC

  • Urgent Care Clinic/Center
  • Oklahoma City, OK
  • NPI 1164697694
  Medicare reassignment Care Compare group NPD (past)
• Absentee Shawnee Tribal Health Authority, Inc.

  dba Absentee Shawnee Tribal Health System - Shawnee Clinic

  • Multi-Specialty Clinic/Center
  • Shawnee, OK
  • NPI 1942253521
  Medicare reassignment
• Immediate Care of Oklahoma, LLC

  • Urgent Care Clinic/Center
  • Oklahoma City, OK
  • NPI 1780239202
  NPD

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

{
    "created_epoch": "1516924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551657600000",
    "number": "1841798626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15951 LITTLE AXE DR",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730269088",
            "telephone_number": "405-447-0300",
            "fax_number": "405-701-7914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36640 OLD HWY 270",
            "city": "WEWOKA",
            "state": "OK",
            "postal_code": "74884",
            "telephone_number": "405-257-6282"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "803 Nichols Ave",
            "address_purpose": "LOCATION",
            "city": "Tecumseh",
            "state": "OK",
            "postal_code": "748734687",
            "country_code": "US",
            "telephone_number": "405-990-0262",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEATHERAGE",
        "first_name": "LUVEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-26",
        "last_updated": "2019-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "2839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher D. Browning, D.D.S., P.C.
• City of Wewoka
• Tana Lee Clark, RN
• Kirsten Leigh Colbert, LCSW
• Debra Daugomah
• Susan Dethman, CDR
• East Central Oklahoma Family Health Center, Inc. (ECO Family Health Center)
• Andrea Denese Edwards
• Elmwood Manor Nursing Home LLC (Elmwood Manor Nursing Home)
• Tracy Lynn Farrill, PHARMD

• Physician Assistant in Wewoka, OK
• Providers in Wewoka, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.