Catherine Petzinger Deshazo, D.O.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

26737 Issued in MS

Practice address

5480 Goodman Rd
Olive Branch, MS 38654-7902

Phone

(662) 893-9815

Fax

(662) 893-9888

NPI assigned

Apr 21, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

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

Specialty

General Surgery

Education

Midwestern University, Chicago College of Osteopathic Med, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SPG II LLC 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Methodist Healthcare - Olive Branch Hospital Hospital, Olive Branch, MS, CCN 250167

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cdeshazo24029@mlh.direct-ci.com
• Direct secure messaging: gxi6218@yourcarecommunity.org
• Direct secure messaging: cpetzinger394261@direct.hfhs.org

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.

• SPG II LLC

  • Surgery Physician
  • Germantown, TN
  • NPI 1255602587

  MS, Surgery

  Medicare reassignment Care Compare group NPD
• Bolivar Physician Practices LLC

  • Orthopaedic Surgery Physician
  • Cleveland, MS
  • NPI 1063659530

  MS

  Medicare reassignment NPD
• Bolivar Physician Practices LLC

  • Rural Health Clinic/Center
  • Rosedale, MS
  • NPI 1205489689
  NPD
• Bolivar Physician Practices LLC

  • Family Medicine Physician
  • Cleveland, MS
  • NPI 1376787556
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Methodist Healthcare - Olive Branch Hospital

  • General Acute Care Hospital
  • Olive Branch, MS
  • NPI 1912341439

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1398038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701302400000",
    "number": "1962822692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 UNION AVE STE 330",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381046655",
            "telephone_number": "901-478-0966",
            "fax_number": "901-478-0951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5480 GOODMAN RD",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386547902",
            "telephone_number": "662-893-9815",
            "fax_number": "662-893-9888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 E Sunflower Rd",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "MS",
            "postal_code": "387322833",
            "country_code": "US",
            "telephone_number": "312-213-9732",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "28050 Grand River Ave",
            "address_purpose": "LOCATION",
            "city": "Farmington Hills",
            "state": "MI",
            "postal_code": "483365919",
            "country_code": "US",
            "telephone_number": "947-521-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESHAZO",
        "first_name": "CATHERINE",
        "middle_name": "PETZINGER",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-21",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MS",
            "license": "26737",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "5101020893",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Professionals of Mississippi, P.C.
• Bonnie F Dering, FNP-C
• Design Your Wellness, LLC
• Desoto County Senior Care, LLC
• Desoto Diagnostic Imaging, LLC
• Desoto Ear, Nose &Throat
• Desoto Family Medical Practice, P.C.

• All providers in Olive Branch, MS
• Surgery Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.