DARRELL LEE DEDEAUX NP-C
NPI 1023556461
Nurse Practitioner - Primary Care in Fayetteville, NC

Active since February 06, 2017PECOS EnrolledAccepts Medicare Assignment
103 COUNTRY CLUB DR, FAYETTEVILLE, NC 28301(910) 400-7002 Get Directions Write a Review

NPPES record last updated: August 25, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 25, 2019, Feb 6, 2017 (2 updates tracked since 2017).

About Darrell Lee Dedeaux Np-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DARRELL LEE DEDEAUX NP-C (NPI 1023556461) is an individual primary care provider in Fayetteville, North Carolina, licensed in North Carolina (5009303) and active in the NPI registry since February 2017. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1023556461
Entity TypeIndividualMale
Primary Taxonomy363LP2300X
Provider Legal NameDARRELL LEE DEDEAUXCredential: NP-C
Location Address103 COUNTRY CLUB DRFayetteville, NC 28301-7603
Mailing AddressPo Box 746724Atlanta, GA 30374-6724 · (773) 644-3941
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateFebruary 6, 2017
Last NPPES UpdateAugust 25, 20252 updates tracked since enumeration
NPPES CertifiedAugust 25, 2025
NPI 1023556461 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
License Licensed in NC · 5009303
103 COUNTRY CLUB DR, Fayetteville, NC 28301

Secondary Practice Locations 2

Location 1129 T.T. Lanier StreetBuies Creek, NC 27506 · Phone (910) 893-1562 · Fax (910) 814-5727
Location 2380 Knollwood St # 505Winston Salem, NC 27103-1884 · Phone (833) 357-2966

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Darrell Lee Dedeaux Np-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8921379926
PECOS Enrollment IDI20170809003942
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28301 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Family Medicine
103 COUNTRY CLUB DR
FAYETTEVILLE, NC 28301
Pharmacy
103 COUNTRY CLUB DR
FAYETTEVILLE, NC 28301
Pharmacist
103 COUNTRY CLUB DR
FAYETTEVILLE, NC 28301
Pharmacist
103 COUNTRY CLUB DR
FAYETTEVILLE, NC 28301
Family Medicine
103 COUNTRY CLUB DR
FAYETTEVILLE, NC 28301
Internal Medicine
103 COUNTRY CLUB DR
FAYETTEVILLE, NC 28301
Social Worker (Clinical)
103 COUNTRY CLUB DR
FAYETTEVILLE, NC 28301
Physician Assistant
103 COUNTRY CLUB DR
FAYETTEVILLE, NC 28301

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Darrell Dedeaux's NPI number?

The NPI number for Darrell Dedeaux is 1023556461. It was assigned to this individual provider in the NPPES registry on February 6, 2017.

Where is Darrell Dedeaux located?

Darrell Dedeaux practices at 103 Country Club Dr, Fayetteville, NC 28301. The listed phone number is (910) 400-7002.

What is Darrell Dedeaux's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Is Darrell Dedeaux enrolled in Medicare?

Yes. Darrell Dedeaux is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Darrell Dedeaux was last updated on August 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.