Taheisha Rena Deese, NP is a medicare enrolled "Nurse Practitioner" physician in Fayetteville, Georgia. Her current practice location is
1265 Highway 54 W Ste 305, Fayetteville, Georgia. You can reach out to her office (for appointments etc.) via phone at
(770) 719-5660.
Taheisha Rena Deese is licensed to practice in Georgia (license number RN165350) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1205516754.
Physician's Profile
Full Name | Taheisha Rena Deese |
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Gender | Female |
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Speciality | Nurse Practitioner |
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Location | 1265 Highway 54 W Ste 305, Fayetteville, Georgia |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1205516754
- Provider Enumeration Date: 07/20/2023
- Last Update Date: 02/17/2025
Medicare PECOS Information:
- PECOS PAC ID: 0840729778
- Enrollment ID: I20250122002514
Medical Identifiers
Medical identifiers for Taheisha Rena Deese such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1205516754 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208600000X | Surgery | RN165350 (Georgia) | Secondary |
363L00000X | Nurse Practitioner | RN165350 (Georgia) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Taheisha Rena Deese allows following entities to bill medicare on her behalf.
Entity Name | Piedmont Providers Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1548273592 PECOS PAC ID: 9830082825 Enrollment ID: O20040204000321 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Taheisha Rena Deese is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Taheisha Rena Deese, NP 155 Buckeye Ln, Fayetteville, GA 30214-1702 Ph: (229) 425-8130 | Taheisha Rena Deese, NP 1265 Highway 54 W Ste 305, Fayetteville, GA 30214-4537 Ph: (770) 719-5660 |
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