MS. JULIA MARIE DEBOLD PA-C, NPI 1861484693 — NASHVILLE (TN)

NPI 1861484693

14+ Years Experience Individual

MS. JULIA MARIE DEBOLD PA-C

08/18/2005
PROVIDER ENUMERATION DATE
06/14/2016
LAST UPDATE DATE
1861484693
NPI NUMBER

About MS. JULIA MARIE DEBOLD

Sole proprietor? No, Entity Type 1 Provider (Individual) is not a Sole Proprietor.

MS. JULIA MARIE DEBOLD is a provider established in NASHVILLE, TN. The NPI number of MS. JULIA MARIE DEBOLD is 1861484693 and was assigned on 08/18/2005. The practitioners primary taxonomy code is: 363AM0700X with license number: 1119 TN .

Mailing address

  • City: NASHVILLE
  • State: TN
  • Postal code: 372082502
  • Phone: 6154998934
  • Address: 1350 ROSA L PARKS BLVD
  • Address 2: UNIT 429

Primary Practice Address

  • Region : NASHVILLE, TN
  • NPI : 1861484693
  • Phone : 6157308051
  • Postalcode : 372131414
  • Address : 508 DAVIDSON ST #204

Provider taxonomy - Physician Assistant

  • Taxonomy code: 363AM0700X
  • License number: 1119
  • License state: TN

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Contacts:

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  • MS. JULIA MARIE DEBOLD PA-C
  • Address : 508 DAVIDSON ST #204
  • Region : NASHVILLE, TN
  • NPI : 1861484693
  • Phone : 6157308051
  • Postalcode : 372131414

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address508 DAVIDSON ST
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location Address#204
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameNASHVILLE
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameTN
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code372131414
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number6157308051
The telephone number associated with the location address of the provider being identified.
NPI1861484693
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1363AM0700X
Provider Enumeration Date08/18/2005
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated06/14/2016
The date that a record was last updated or changed.
Entity TypeIndividual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)MS. JULIA MARIE DEBOLD
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address1350 ROSA L PARKS BLVD
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Second Line Business Mailing AddressUNIT 429
The second line mailing address of the provider being identified. This data element may contain the same information as "Provider second line location address".
Provider Business Mailing Address City NameNASHVILLE
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameTN
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code372082502
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number6154998934
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Healthcare Provider Taxonomy Code #1363AM0700X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Physician Assistant
Provider License Number 11119
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1TN
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Provider Gender CodeF
  • M - male
  • F - female
Is sole proprietorN
  • X - Not Answered
  • Y - Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor
  • N - No, Entity Type 1 Provider (Individual) is not a Sole Proprietor
X

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