Jordann Elizabeth Deacon, PA-C

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

0010-12912 Issued in NC

Practice address

2630 E 7TH St Ste 200
Charlotte, NC 28204-4319

Phone

(704) 364-6110

Fax

(704) 364-4245

NPI assigned

Jun 9, 2022

Last updated

Sep 27, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 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

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Metrolina Dermatology and Skin Surgery Specialists PLLCGroup PAC ID 3173891892, 39 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

84.08 of 100Reported as group

Quality

81.28

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jdeacon@metrolinadermatology.emadirect.md
• Direct secure messaging: jordannd@charlottederm.emadirect.md

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.

• Metrolina Dermatology and Skin Surgery Specialists, PLLC

  • Dermatology Physician
  • Charlotte, NC
  • NPI 1619400033
  Medicare reassignment Care Compare group
• Charlotte Dermatology PA

  • Dermatology Physician
  • Charlotte, NC
  • NPI 1265477251

  Single Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1654732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1942939392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2630 E 7TH ST STE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282044319",
            "telephone_number": "704-364-6110",
            "fax_number": "704-364-4245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 E 7TH ST STE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282044319",
            "telephone_number": "704-364-6110",
            "fax_number": "704-364-4245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEACON",
        "first_name": "JORDANN",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-09",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "NC",
            "license": "0010-12912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindamulage Malintha De Silva
• Daniel Marc De Simon, MD, MBA
• Daniel De Souza, MD
• Maria Lena Dea, PT, DPT
• Deacon Care Transport LLC
• Katie A Deal
• Mary Carver Deal
• Stephen Edgar Deal, M.D.
• Tricia Lyn Deal, CRNA
• Allyson Dean, PHARM.D.

• Dermatology Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Dermatology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2023; 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.