1. Home
  2. Directory
  3. North Carolina
  4. Lillington
  5. Physician Assistant
  6. NPI Profile

JOHNATHAN DONALD DEBETTA
NPI 1164003570
Physician Assistant in Lillington, NC

Active since April 16, 2021
4350 US 421 S, LILLINGTON, NC 27546(910) 893-1210 Get Directions Write a Review

NPPES record last updated: December 7, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 7, 2021, Apr 16, 2021 (2 updates tracked since 2021).

About Johnathan Donald Debetta NPPES

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

JOHNATHAN DONALD DEBETTA (NPI 1164003570) is an individual physician assistant in Lillington, North Carolina, licensed in North Carolina (0010-11534) and active in the NPI registry since April 2021.

NPPES Registry Identity

NPI1164003570
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameJOHNATHAN DONALD DEBETTA
Location Address4350 US 421 SLillington, NC 27546-6760
Mailing Address10118 Knotty Pine LnRaleigh, NC 27617-8218 · (631) 678-8049
Phone(910) 893-1210
Sole ProprietorNo
Enumeration DateApril 16, 2021
Last NPPES UpdateDecember 7, 20212 updates tracked since enumeration
NPPES CertifiedDecember 7, 2021
✔ NPI 1164003570 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in NC · 0010-11534
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
4350 US 421 S, Lillington, NC 27546
Open in Google Maps ↗

Other Providers at the Same Location NPPES 20

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

GRACE GLASS
Physician Assistant
4350 US 421 S
LILLINGTON, NC 27546
Harnett County (910) 893-1210
ANNA FINESTONE LEVIERE
Physician Assistant
4350 US 421 S
LILLINGTON, NC 27546
Harnett County (910) 893-1210
AYDAN LUKE HEAVNER
Physician Assistant
4350 US 421 S
LILLINGTON, NC 27546
Harnett County (910) 893-1210
TIFFANY TIMPSON PA
Student in an Organized Health Care Education/Training Program
4350 US 421 S
LILLINGTON, NC 27546
Harnett County (910) 893-1210
HOLLY PRICE
Student in an Organized Health Care Education/Training Program
4350 US 421 S
LILLINGTON, NC 27546
Harnett County (800) 334-4111
JASMINE NGUYEN
Physician Assistant
4350 US 421 S
LILLINGTON, NC 27546
Harnett County (910) 893-1210
SARA MOODY
Physician Assistant
4350 US 421 S
LILLINGTON, NC 27546
Harnett County (910) 893-1210
TRESTON GRANT CLARK-LARUE PA-C
Physician Assistant
4350 US 421 S
LILLINGTON, NC 27546
Harnett County (910) 893-1210

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 Johnathan Debetta's NPI number?

The NPI number for Johnathan Debetta is 1164003570. It was assigned to this individual provider in the NPPES registry on April 16, 2021.

Where is Johnathan Debetta located?

Johnathan Debetta practices at 4350 Us 421 S, Lillington, NC 27546. The listed phone number is (910) 893-1210.

What is Johnathan Debetta's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Johnathan Debetta was last updated on December 7, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.