Rebecca Ann Ahlstrom, APRN, CNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

167377-9 Issued in MN

Practice address

21897 S Diamond Lake Rd Ste 400-403
Rogers, MN 55374-4642

Phone

(763) 317-1122

Fax

(855) 282-6764

NPI assigned

Sep 21, 2007

Last updated

Aug 31, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Integrative Geriatrics, PLLC

  • Gerontology Nurse Practitioner
  • Rogers, MN
  • NPI 1932620796
  Authorized official Same address or phone

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

{
    "created_epoch": "1190332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1033305115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21897 S DIAMOND LAKE RD STE 400-403",
            "city": "ROGERS",
            "state": "MN",
            "postal_code": "553744642",
            "telephone_number": "763-317-1122",
            "fax_number": "855-282-6764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21897 S DIAMOND LAKE RD STE 400-403",
            "city": "ROGERS",
            "state": "MN",
            "postal_code": "553744642",
            "telephone_number": "763-317-1122",
            "fax_number": "855-282-6764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHLSTROM",
        "first_name": "REBECCA",
        "middle_name": "ANN",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-21",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MN",
            "license": "167377-9",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• A Better Living Care Services, LLC
• A Gentle Dental Center of Rogers
• Adoptive Steps Therapy Inc
• Aegis Group Practice LLC
• Affinity Living Assistance Co
• Shamsa Ahmed
• Daniel A Albright, M.D.
• Diane Menzies Alderman, NP
• Rawan Nassar Faour Alhmoud
• Devon M Allen, MD

• Gerontology Nurse Practitioner in Rogers, MN
• Providers in Rogers, MN by specialty
• Gerontology Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.