Darrell L Dedeaux (NPI# 1023556461, PAC ID# 8921379926) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1023556461 |
| PAC ID by PECOS | 8921379926 |
| Professional Enrollment ID | I20170809003942 |
| Full Name | Darrell L Dedeaux |
| Organization Legal Name | CAMPBELL UNIVERSITY HEALTH CENTER LLC |
| Address |
129 Tt Lanier St Buies Creek NC 27506 |
| Phone Number | 9108931562 |
| Gender | M |
| Graduation Year | 2016 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 1254586308 |
| Number of Group Practice Members | 10 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 340071 | BETSY JOHNSON REGIONAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 129 Tt Lanier St, Buies Creek, NC 27506 | 9108931562 | CAMPBELL UNIVERSITY HEALTH CENTER LLC |
| Organization Legal Name | CAMPBELL UNIVERSITY HEALTH CENTER LLC |
| Physicians | 15 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Shaun C Knox | Internal Medicine | Campbell University Health Center LLC | 608 Tilghman Dr, Dunn, NC 28334-5525 |
| Lucy W Ertenberg | Family Medicine | Campbell University Health Center LLC | 129 Tt Lanier St, Buies Creek, NC 27506 |
| Leigh C Byrd | Physician Assistant | Campbell University Health Center LLC | 129 Tt Lanier St, Buies Creek, NC 27506 |
| Amanda Warren Lee | Physician Assistant | Campbell University Health Center LLC | 129 Tt Lanier St, Buies Creek, NC 27506 |
| Thomas M Motyka | Internal Medicine | Campbell University Health Center LLC | 129 Tt Lanier St, Buies Creek, NC 27506 |
| Eric E Gish | Osteopathic Manipulative Medicine | Campbell University Health Center LLC | 129 Tt Lanier St, Buies Creek, NC 27506 |
| Charlotte A Paolini | Family Medicine | Campbell University Health Center LLC | 129 Tt Lanier St, Buies Creek, NC 27506 |
| Ryan K Hudson | Family Medicine | Campbell University Health Center LLC | 129 Tt Lanier St, Buies Creek, NC 27506 |
| Andrew T Martin | Family Medicine | Campbell University Health Center LLC | 129 Tt Lanier St, Buies Creek, NC 27506 |
| Cynthia Dawn Lee | Nurse Practitioner | Campbell University Health Center LLC | 129 Tt Lanier St, Buies Creek, NC 27506 |
| Street Address |
129 TT LANIER ST |
| City | BUIES CREEK |
| State | NC |
| Zip | 27506 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lucy W Ertenberg | Family Medicine | Campbell University Health Center LLC | 129 Tt Lanier St, Buies Creek, NC 27506 |
| Leigh C Byrd | Physician Assistant | Campbell University Health Center LLC | 129 Tt Lanier St, Buies Creek, NC 27506 |
| Amanda Warren Lee | Physician Assistant | Campbell University Health Center LLC | 129 Tt Lanier St, Buies Creek, NC 27506 |
| Thomas M Motyka | Internal Medicine | Campbell University Health Center LLC | 129 Tt Lanier St, Buies Creek, NC 27506 |
| Eric E Gish | Osteopathic Manipulative Medicine | Campbell University Health Center LLC | 129 Tt Lanier St, Buies Creek, NC 27506 |
| Charlotte A Paolini | Family Medicine | Campbell University Health Center LLC | 129 Tt Lanier St, Buies Creek, NC 27506 |
| Ryan K Hudson | Family Medicine | Campbell University Health Center LLC | 129 Tt Lanier St, Buies Creek, NC 27506 |
| Andrew T Martin | Family Medicine | Campbell University Health Center LLC | 129 Tt Lanier St, Buies Creek, NC 27506 |
| Cynthia Dawn Lee | Nurse Practitioner | Campbell University Health Center LLC | 129 Tt Lanier St, Buies Creek, NC 27506 |
| Charles J Smutny Iii | Osteopathic Manipulative Medicine | Campbell University Health Center LLC | 129 Tt Lanier St, Buies Creek, NC 27506 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Nicholas Pennings | Family Medicine | Campbell University Health Center LLC | 129 Tt Lanier St, Buies Creek, NC 27506 |
| Gregory A Hon | Sports Medicine | Campbell University Health Center LLC | 129 Tt Lanier St, Buies Creek, NC 27506 |
| Lisa R Chun | Osteopathic Manipulative Medicine | Campbell University Health Center LLC | 129 Tt Lanier St, Buies Creek, NC 27506 |
| Edward C Smith | Clinical Social Worker | Daymark Recovery Services Inc | 5841 Us Hwy 421 S, Buies Creek, NC 27506-0457 |
| Lauren O'reilly | Clinical Social Worker | Daymark Recovery Services Inc | 5841 Us Hwy 421 S, Buies Creek, NC 27506-0457 |
| City | BUIES CREEK |
| Zip Code | 27506 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | BUIES CREEK + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Darrell L Dedeaux.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.