Individual provider Active NPI

Deborah H Ralston, MD

  • Family Medicine Physician
  • Shellsburg, IA
National Provider Identifier
1063432953
Registry record updated May 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
42151 Issued in WI
Practice address
6007 33Rd Avenue Dr
Shellsburg, IA 52332-9569
Phone
(920) 716-9925
NPI assigned
Jul 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 42151 WI Primary

Addresses

Primary practice location

6007 33Rd Avenue Dr
Shellsburg, IA 52332-9569

Mailing address

905 Franklin St
Waterloo, IA 50703-4407
Phone (319) 874-3000

Other identifiers 2

IdentifierTypeStateIssuer
0076372MedicaidIA
34010900MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180119000965 IA Practitioner - Family Practice 9234222035 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

905 Franklin St
Waterloo, IA 50703-4407
Phone (319) 874-3000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Thedacare, Incorporated Family Medicine Current Accepting new patients
Peoples Community Health Clinic, Inc CurrentSince May 15, 2018 Accepting new patients
Peoples Community Health Clinic, Inc. CurrentSince May 15, 2018 Accepting new patients
Peoples Community Health Clinic, Inc Current Accepting new patients
Prevea Regional Services, Inc. Family Medicine Past Accepting new patients
Eastern Iowa Health Center Family Medicine Past Accepting new patients

Locations

905 Franklin St
Waterloo, IA 50703
Phone (319) 272-4300

3916 N Intertech Ct
Appleton, WI 54913
Phone (920) 996-1000

1405 Mill St
New London, WI 54961
Phone (920) 531-2000

Interoperability endpoints

  • Direct secure messaging: dralston635238@direct.ochin.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525132800000",
    "number": "1063432953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 FRANKLIN ST",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507034407",
            "telephone_number": "319-874-3000",
            "fax_number": "319-874-3411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6007 33RD AVENUE DR",
            "city": "SHELLSBURG",
            "state": "IA",
            "postal_code": "523329569",
            "telephone_number": "920-716-9925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RALSTON",
        "first_name": "DEBORAH",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2018-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "42151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0076372",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34010900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shellsburg, IA

Sources for this page

Verify at the official NPI Registry.