Deborah M Middleton

Primary specialty

Social WorkerTaxonomy code 104100000X

License

002265 Issued in MO

Practice address

3405 W. Truman, 101
Jefferson City, MO 65109-5861

Phone

(573) 864-7868

Fax

(573) 864-7868

NPI assigned

Dec 5, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Deborah M Bomke Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292889600000",
    "number": "1578621009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1424 BOYD LN",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652022813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3405 W. TRUMAN, 101",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651095861",
            "telephone_number": "573-864-7868",
            "fax_number": "573-864-7868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDDLETON",
        "first_name": "DEBORAH",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2010-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MO",
            "license": "002265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "493615124",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBORAH",
            "last_name": "BOMKE",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mid Missouri Medical Consultants, Inc.
• Mid-Missouri Anesthesia Consultants PC
• Mid-Missouri ENT and Facial Plastic Surgery Specialsts Inc.
• Mid-Mo O&P LLC
• Kevin Michel Middlemist, D.O.
• Midwest Respiratory Care Inc.
• Donald P. Miller, M.D.
• Jonas Daniel Miller, DDS
• Molly Beth Miller
• William Miller, OD

• Social Worker in Jefferson City, MO
• Providers in Jefferson City, MO by specialty
• Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.