Individual provider Active NPI

Debbie L Costa, RN

  • Home Health Registered Nurse
  • Blanco, TX
National Provider Identifier
1700975109
Registry record updated Feb 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
639607 Issued in TX
Practice address
490 Buffalo Gulch
Blanco, TX 78606-4508
Phone
(830) 833-5011
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 639607 TX
Home Health Registered Nurse 163WH0200X 639607 TX Primary

Addresses

Primary practice location

490 Buffalo Gulch
Blanco, TX 78606-4508

Mailing address

PO Box 900
Blanco, TX 78606-0900

Other identifiers 1

IdentifierTypeStateIssuer
1001992MedicaidTX

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
639607TXMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201824000000",
    "number": "1700975109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 900",
            "city": "BLANCO",
            "state": "TX",
            "postal_code": "786060900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 BUFFALO GULCH",
            "city": "BLANCO",
            "state": "TX",
            "postal_code": "786064508",
            "telephone_number": "830-833-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTA",
        "first_name": "DEBBIE",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2008-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "639607",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "TX",
            "license": "639607",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1001992",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blanco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2008; 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.