DEBRA L ADAMS-KOLTES, RN — NPI 1649876145 (Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Psychiatric

CMS-1500 Box 24J / 33a • NPI

1649876145

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

364SP0808X (CMS 89)

Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Psychiatric — Mental Health

Box 32 Service Location & ZIP+4

5322 GRAND AVE, DULUTH, MN, 55807-2595

✓ 9-Digit EDI 837 ZIP+4 (55807-2595)

Practice Phone & Referral Fax

(218) 724-2800

Fax: (218) 724-8200

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1649876145 (DEBRA L ADAMS-KOLTES, RN) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1649876145` (NPI-1 Individual Practitioner)
Provider / Legal Name	DEBRA L ADAMS-KOLTES, RN
Plain-English Specialty	Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Psychiatric — Mental Health NUCC Code: `364SP0808X` (Clinical Nurse Specialist, Psych/Mental Health)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	5322 GRAND AVE, DULUTH, MN, 55807-2595
Practice Telephone / Fax	Tel: (218) 724-2800 \| Fax: (218) 724-8200
Administrative Mailing Address	5322 GRAND AVE, DULUTH, MN, 55807-2595
Enumeration & Last Sync	Enumerated: 2020-12-09 \| CMS Record Updated: 2020-12-09

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

5322 GRAND AVE, DULUTH, MN, 55807-2595

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Plain-English Taxonomy & CMS Crosswalk (364SP0808X)

What Does Taxonomy Code 364SP0808X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 364SP0808X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Psychiatric — Mental Health"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 89 (Certified Clinical Nurse Specialist)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Clinical Nurse Specialist, Psych/Mental Health for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (DEBRA L ADAMS-KOLTES, RN)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`364SP0808X` — Clinical Nurse Specialist, Psych/Mental Health Plain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Clinical Nurse Specialist, Psychiatric — Mental Health	State: MN \| License: `R127441-1` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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DEBRA L ADAMS-KOLTES, RN (NPI #1649876145)