Individual provider Active NPI

Deborah Anne Congdon, ARNP-BC

  • Family Nurse Practitioner
  • Tallahassee, FL
National Provider Identifier
1073806782
Registry record updated Jun 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN9198007 Issued in FL
Practice address
8112 Blue Quill TRL
Tallahassee, FL 32312-3620
Phone
(850) 273-2580
NPI assigned
May 27, 2011
Last updated
Jun 28, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN9198007 FL Primary

Addresses

Primary practice location

8112 Blue Quill TRL
Tallahassee, FL 32312-3620

Mailing address

8112 Blue Quill TRL
Tallahassee, FL 32312-3620

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210923000044 FL Order and Referring Only - Nurse Practitioner 1254504442

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN9198007FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Authority of the City of Bainbridge and Decatur County Past 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": "1306454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372377600000",
    "number": "1073806782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8112 BLUE QUILL TRL",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323123620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8112 BLUE QUILL TRL",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323123620",
            "telephone_number": "850-273-2580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONGDON",
        "first_name": "DEBORAH",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "ARNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-27",
        "last_updated": "2013-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "RN9198007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.