Active NPI
John Roger Rebillot, M. A.
- Mental Health Counselor
- Santa Rosa Beach, FL
National Provider Identifier
1003045105
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MH915
- Practice address
- 141 Mack Bayou Loop
Suite 201
Santa Rosa Beach, FL 32459-7194 - Phone
- (850) 267-0030
- Fax
- (850) 267-0034
- NPI assigned
- Jul 9, 2009
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MH915 | FL | Primary |
Addresses
Primary practice location
141 Mack Bayou Loop
Suite 201
Santa Rosa Beach, FL 32459-7194
Mailing address
255 13TH Ave NE
St Petersburg, FL 33701-1211
Phone (727) 825-0751
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
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MH915 | FL | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memory Bridging Incorporated | Past | Accepting new patients | |
| Rementis Health Group LLC | Past | Accepting new patients |
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.
-
- Community/Behavioral Health Agency
- Destin, FL
- NPI 1417108200
-
- Cognitive & Behavioral Psychologist
- Parker, CO
- NPI 1386827293
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247097600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1247097600000",
"number": "1003045105",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "255 13TH AVE NE",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337011211",
"telephone_number": "727-825-0751"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "141 MACK BAYOU LOOP",
"address_2": "SUITE 201",
"city": "SANTA ROSA BEACH",
"state": "FL",
"postal_code": "324597194",
"telephone_number": "850-267-0030",
"fax_number": "850-267-0034"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REBILLOT",
"first_name": "JOHN",
"middle_name": "ROGER",
"credential": "M. A.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-07-09",
"last_updated": "2009-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH915",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Rosa Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.