Individual provider Active NPI

Deborah Jo Myers, FNP

  • Family Nurse Practitioner
  • Mooresville, NC
National Provider Identifier
1477737567
Registry record updated Jul 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0050-03875 Issued in NC
Practice address
550 Glenwood Dr
Mooresville, NC 28115-2876
Phone
(704) 664-7494
Fax
(704) 664-9642
NPI assigned
Dec 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2012

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 0050-03875 NC Primary

Addresses

Primary practice location

550 Glenwood Dr
Mooresville, NC 28115-2876

Mailing address

550 Glenwood Dr
Mooresville, NC 28115-2876
Phone (704) 664-7494

Other identifiers 1

IdentifierTypeStateIssuer
7003923MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20090821000350 NC Practitioner - Nurse Practitioner 1153475389 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0050-03875NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pacs, PC CurrentSince Jan 1, 2020 Accepting new patients
Alignmed Partners, PC CurrentSince Jan 1, 2018 Accepting new patients

Locations

6508 Deer Pointe Dr
Ste A
Salisbury, MD 21804

10021 Park Cedar Dr
Ste 200
Charlotte, NC 28210
Phone (704) 438-9383

707 N Elm St
High Point, NC 27262
Phone (336) 885-0141

877 Hill Everhart Rd
Lexington, NC 27295
Phone (336) 248-6644

550 Glenwood Dr
Mooresville, NC 28115
Phone (704) 644-4797

710 Julian Rd
Salisbury, NC 28147
Phone (704) 636-5812

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1198627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341187200000",
    "number": "1477737567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 GLENWOOD DR",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281152876",
            "telephone_number": "704-664-7494",
            "fax_number": "704-664-9642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 GLENWOOD DR",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281152876",
            "telephone_number": "704-664-7494",
            "fax_number": "704-664-9642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "DEBORAH",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-26",
        "last_updated": "2012-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "0050-03875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7003923",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

Verify at the official NPI Registry.