Individual provider Active NPI

Deborah Booher Kolb, M.D.

  • Family Medicine Physician
  • Madison, AL
National Provider Identifier
1063493153
Registry record updated Jul 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
22818 Issued in AL
Practice address
8371 Highway 72 W
Suite 200
Madison, AL 35758-9505
Phone
(256) 722-0664
Fax
(256) 722-0285
NPI assigned
Nov 7, 2005
Last updated
Jul 24, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2007

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 22818 AL Primary

Addresses

Primary practice location

8371 Highway 72 W
Suite 200
Madison, AL 35758-9505

Mailing address

8371 Highway 72 W
Suite 200
Madison, AL 35758-9505
Phone (256) 722-0664

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20100915000731 AL Practitioner - Family Practice 4183749054 Practice locations: Madison, AL

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22818ALMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Deborah Booher Kolb, M.D., P.C. Family Medicine PastSince Jul 30, 2001 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185235200000",
    "number": "1063493153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8371 HIGHWAY 72 W",
            "address_2": "SUITE 200",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357589505",
            "telephone_number": "256-722-0664",
            "fax_number": "256-722-0285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8371 HIGHWAY 72 W",
            "address_2": "SUITE 200",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357589505",
            "telephone_number": "256-722-0664",
            "fax_number": "256-722-0285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLB",
        "first_name": "DEBORAH",
        "middle_name": "BOOHER",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-07",
        "last_updated": "2007-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "22818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, AL

Sources for this page

Verify at the official NPI Registry.