Individual provider Active NPI

Rebecca Agnes Wilshere, M.D.

  • Family Medicine Physician
  • Florence, KY
National Provider Identifier
1003835455
Registry record updated May 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35903 Issued in KY
Practice address
7309 US Highway 42
Florence, KY 41042-5561
Phone
(859) 282-1241
Fax
(859) 282-7087
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35903 KY Primary

Addresses

Primary practice location

7309 US Highway 42
Florence, KY 41042-5561

Mailing address

7309 US Highway 42
Florence, KY 41042-5561
Phone (859) 282-1241

Other identifiers 1

IdentifierTypeStateIssuer
64127897MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071008000064 KY Practitioner - Family PracticePractitioner - Internal Medicine 0244296564 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Internal Medicine
Education
University of Louisville School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5 Lakeshore Dr
Florence, KY 41042-9790
Phone (859) 468-9155

Hospital & facility affiliations

  • St Elizabeth Florence Hospital, Florence, KY, CCN 180045
  • St Elizabeth Edgewood Hospital, Edgewood, KY, CCN 180035
  • Gateway Rehabilitation Hospital Inpatient rehabilitation facility, Florence, KY, CCN 183030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Imw Consulting, PLLC CurrentSince Mar 10, 2021 Accepting new patients
L.B. Payne D.C. P.S.C. Past Accepting new patients
Vibra Rehabilitation Hospital of Florence LLC Past Accepting new patients

Locations

5940 Merchants St
Florence, KY 41042
Phone (859) 391-4814

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464048000000",
    "number": "1003835455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7309 US HIGHWAY 42",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "410425561",
            "telephone_number": "859-282-1241",
            "fax_number": "859-282-7087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7309 US HIGHWAY 42",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "410425561",
            "telephone_number": "859-282-1241",
            "fax_number": "859-282-7087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSHERE",
        "first_name": "REBECCA",
        "middle_name": "AGNES",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2016-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "35903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64127897",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, KY

Sources for this page

Verify at the official NPI Registry.