Individual provider Active NPI

Rachel Lynn Bott, CRNP

  • Family Nurse Practitioner
  • Lebanon, PA
National Provider Identifier
1023550225
Registry record updated Jun 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP016795 Issued in PA
Practice address
252 S 4TH St FL 2
Lebanon, PA 17042-6111
Phone
(717) 270-3751
NPI assigned
Nov 6, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN596533 PA
Family Nurse Practitioner 363LF0000X MB4158069 PA
Family Nurse Practitioner 363LF0000X SP016795 PA Primary

Addresses

Primary practice location

252 S 4TH St FL 2
Lebanon, PA 17042-6111

Mailing address

601 Memory LN
York, PA 17402-2231
Phone (717) 851-1405

Other practice location 1

301 S 7th Ave
Reading, PA 19611-1410
Phone (484) 628-8000

Other practice location 2

179 N Reading Rd
Ephrata, PA 17522-1647
Phone (717) 738-0167

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240706000502 PA Practitioner - Nurse Practitioner 0840734471 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN596533PAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group CurrentSince Jun 21, 2024 Accepting new patients
Wellspan Medical Group Current Accepting new patients
Wellspan Medical Group CurrentSince Jun 21, 2024 Accepting new patients

Locations

179 N Reading Rd
Ephrata, PA 17522
Phone (717) 738-0167

252 S 4th St
Fl 2
Lebanon, PA 17042
Phone (717) 270-3751

252 S 4th St
#2
Lebanon, PA 17042
Phone (717) 270-3751

1600 S George St
York, PA 17403
Phone (717) 848-3615

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

601 Memory Ln
York, PA 17402
Phone (717) 851-6670

Interoperability endpoints

  • Direct secure messaging: rbott440333@wellspan.direct-ci.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1478390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1023550225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 MEMORY LN",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174022231",
            "telephone_number": "717-851-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "252 S 4TH ST FL 2",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170426111",
            "telephone_number": "717-270-3751"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 S 7th Ave",
            "address_purpose": "LOCATION",
            "city": "Reading",
            "state": "PA",
            "postal_code": "196111410",
            "country_code": "US",
            "telephone_number": "484-628-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "179 N Reading Rd",
            "address_purpose": "LOCATION",
            "city": "Ephrata",
            "state": "PA",
            "postal_code": "175221647",
            "country_code": "US",
            "telephone_number": "717-738-0167",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOTT",
        "first_name": "RACHEL",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-06",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN596533",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "MB4158069",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP016795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, PA

Sources for this page

Verify at the official NPI Registry.