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DESTINA SHANTE REID PA-C
NPI 1790311223
Physician Assistant in Lagrange, GA

Active since March 16, 2020PECOS Enrolled
108 EDGEWOOD AVE, LAGRANGE, GA 30241(706) 415-0370 Get Directions Write a Review

NPPES record last updated: March 16, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Destina Shante Reid Pa-c NPPES

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

DESTINA SHANTE REID PA-C (NPI 1790311223) is an individual physician assistant in Lagrange, Georgia, licensed in Georgia (9661) and active in the NPI registry since March 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1790311223
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameDESTINA SHANTE REIDCredential: PA-C
Location Address108 EDGEWOOD AVELagrange, GA 30241-6116
Mailing Address108 Edgewood AveLagrange, GA 30241-6116 · (706) 415-0370
Phone(706) 415-0370
Sole ProprietorNo
Enumeration DateMarch 16, 2020
NPPES CertifiedMarch 16, 2020
✔ NPI 1790311223 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 GA · 9661
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.
108 EDGEWOOD AVE, Lagrange, GA 30241
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Other Names 1

Former Name (1)Destina Shante Campbell

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Destina Shante Reid Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 30241 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
$83.23 typical visit price
range $53.31 – $164.04
Typical copayment $20.80 (range $13.32 – $41.01)
Most-billed visit code 99203
Established Patient
$66.89 typical visit price
range $16.68 – $133.24
Typical copayment $16.72 (range $4.17 – $33.31)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Destina Reid's NPI number?

The NPI number for Destina Reid is 1790311223. It was assigned to this individual provider in the NPPES registry on March 16, 2020. The provider is also known as Destina Shante Campbell.

Where is Destina Reid located?

Destina Reid practices at 108 Edgewood Ave, Lagrange, GA 30241. The listed phone number is (706) 415-0370.

What is Destina Reid's specialty?

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

Is Destina Reid enrolled in Medicare?

Yes. Destina Reid is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Destina Reid was last updated on March 16, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.