Individual provider Active NPI

Rebecca M. Jeppson, FNP-C

  • Family Nurse Practitioner
  • Rexburg, ID
National Provider Identifier
1033351895
Registry record updated Feb 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP920A Issued in ID
Practice address
15 Madison Professional Park
Rexburg, ID 83440-2057
Phone
(208) 356-6185
Fax
(208) 356-0378
NPI assigned
Mar 25, 2009
Last updated
Feb 24, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP920A ID Primary
Registered Nurse 163W00000X N16709 ID

Addresses

Primary practice location

15 Madison Professional Park
Rexburg, ID 83440-2057

Mailing address

848 S 7TH W
Sugar City, ID 83448-5060
Phone (208) 356-6185

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20091013000426 ID Practitioner - Nurse Practitioner 0042356644 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vista Healthcare PCGroup PAC ID 4587921788, 5 clinicians

Practice addresses (Care Compare)

570 Trejo St
Rexburg, ID 83440-2627
Phone 20888109025

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N16709IDMDRegistered Nurse
NP920AIDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vista Healthcare PC Nurse Practitioner CurrentSince Sep 15, 2017 Accepting new patients
Eagle Rock Physical Therapy PLLC Past Accepting new patients

Locations

556 Trejo St
Ste B
Rexburg, ID 83440
Phone (208) 359-2263

570 Trejo St
Rexburg, ID 83440
Phone (208) 881-0902

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1237939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614124800000",
    "number": "1033351895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "848 S 7TH W",
            "city": "SUGAR CITY",
            "state": "ID",
            "postal_code": "834485060",
            "telephone_number": "208-356-6185",
            "fax_number": "208-356-0378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 MADISON PROFESSIONAL PARK",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834402057",
            "telephone_number": "208-356-6185",
            "fax_number": "208-356-0378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEPPSON",
        "first_name": "REBECCA",
        "middle_name": "M.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-25",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "NP920A",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ID",
            "license": "N16709",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rexburg, ID

Sources for this page

Verify at the official NPI Registry.