Nicholas Destefano, MD
Nicholas Destefano, MD is a General Practice Physician in Fort Gordon, GA, registered under NPI 1154776755. This provider registers 2 separate taxonomy codes, which usually means they practise across more than one recognised specialty.
Getting there
The practice address on file is 300 E HOSPITAL RD, Fort Gordon, GA 30905. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| 30177 | NE | General Practice Physician primary |
| C1-0028577 | DE | Family Medicine Physician |
Licences are recorded in 2 states: NE, DE. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.
- Status
- Approved
- Provider type
- Practitioner - Family Practice
- PAC ID
- 0446542229
Medicare enrolment is recorded as approved under the provider type Practitioner - Family Practice. This means the provider is enrolled to bill Medicare, though it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
Licensed in 2 states
This provider holds licences in 2 states: Delaware and Nebraska. Multi-state licensure often means the provider works near a state border, covers more than one office, or delivers care by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.
Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.
What General Practice covers
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. NUCC Health Care Provider Taxonomy, code 208D00000X
All registered taxonomy codes
This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 208D00000X | General Practice Physician | 30177 | NE | primary |
| 207Q00000X | Family Medicine Physician | C1-0028577 | DE |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1154776755 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | May 2, 2016 |
| Last updated | Dec 10, 2025 |
| Status | Active |
| Sole proprietor | No |
| Credential | MD |
| Practice address |
300 E HOSPITAL RD Fort Gordon, GA 30905 (706) 383-5299 |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 1 | 5 | 4 | 7 | 7 | 6 | 7 | 5 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 1 | 1 | 4 | 5 | 7 | 3 | 7 | 1 |
Sum = 55 · next multiple of 10 = 60 · check digit = 5 · actual last digit = 5
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.