Active NPI
Alicia Angeline Debord, PT
- Physical Therapist
- Boone, NC
National Provider Identifier
1700903507
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 9300
- Practice address
- 336 Deerfield Rd
Boone, NC 28607-5008 - Phone
- (828) 268-9043
- Fax
- (828) 268-9045
- NPI assigned
- Mar 25, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 9300 | NC | Primary |
Addresses
Primary practice location
336 Deerfield Rd
Boone, NC 28607-5008
Mailing address
451 Heritage Oaks LN
Jefferson, NC 28640-9837
Phone (336) 263-5022
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3400051 | Medicaid | NC |
Other names 1
- Alicia Angeline Maxwell
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9300 | NC | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424131200000",
"number": "1700903507",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "451 HERITAGE OAKS LN",
"city": "JEFFERSON",
"state": "NC",
"postal_code": "286409837",
"telephone_number": "336-263-5022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "336 DEERFIELD RD",
"city": "BOONE",
"state": "NC",
"postal_code": "286075008",
"telephone_number": "828-268-9043",
"fax_number": "828-268-9045"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEBORD",
"first_name": "ALICIA",
"middle_name": "ANGELINE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-25",
"last_updated": "2015-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "9300",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3400051",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ALICIA",
"last_name": "MAXWELL",
"middle_name": "ANGELINE",
"credential": "PT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Boone, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.