CHAVONN L DEDEAUX (FNP-C) – Family Nurse Practitioner, NPI 1255717096

CHAVONN L DEDEAUX (FNP-C) is a healthcare provider. based in Gary, Indiana. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP-C. They hold a License No. F03240103 (IN). The NPI Number for CHAVONN L DEDEAUX (FNP-C) is 1255717096

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
CHAVONN L DEDEAUX (FNP-C)
NPI
1255717096
Phone
(708) 271-3973
Address
4187 JEFFERSON ST
Enumeration Date
4 August 2015
Last Update Date
20 March 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2198854264
Graduation Year
2023 (3 years ago)
PAC ID
8921533472
Group Practice PAC ID
9234398397
Professional Enrollment ID
I20241121001211
Address ID
IN464021711GA1100XAVEX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:10State licenses:3Digital endpointsOther names

8,191 NURSE PRACTITIONER in IN

Provider Addresses for CHAVONN L DEDEAUX (FNP-C)

  • 4187 JEFFERSON ST

    GARY, IN 464082833

    Phone: (708) 271-3973

    Type: Mailing

  • 3535 Broadway

    Gary, IN 464091316

    Phone: (219) 884-4900

    Type: Location

  • 4747 W 24th Ave

    Gary, IN 464062821

    Phone: (219) 885-4264

    Type: Location

  • 1100 W 6th Ave

    Gary, IN 464021711

    Phone: (219) 885-4264

    Type: Location

  • 4747 W 24TH AVE

    GARY, IN 464062821

    Phone: (219) 885-4264

    Type: Location

  • 5495 BROADWAY

    MERRILLVILLE, IN 464101647

    Phone: (219) 884-4900

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 17 Open Payments records for all available years, with a total value of $709.

Total Amount is formed as General ($709) + Research ($0) + Ownership ($0) = $709.

Last reported payment date: 2024-11-06 • Largest payer in this snapshot: Otsuka America Pharmaceutical, Inc. ($164).

Total Amount

$709

General + Research + Ownership

Payments

17

Total payment records

General Amount

$709

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-06

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-11-21

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241121001211INurse PractitionerINTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 46408)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9234398397View full group profile

Reviews

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Frequently asked questions

What NPI should I save for CHAVONN L DEDEAUX (FNP-C)?
Save NPI 1255717096 if you need a stable reference for CHAVONN L DEDEAUX (FNP-C).
Is CHAVONN L DEDEAUX (FNP-C)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What does CHAVONN L DEDEAUX (FNP-C) treat or focus on?
Patients typically see CHAVONN L DEDEAUX (FNP-C) under the specialty Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where is CHAVONN L DEDEAUX (FNP-C)'s primary listing?
We display Gary, Indiana because that is what the record indicates for CHAVONN L DEDEAUX (FNP-C).
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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