Individual provider Active NPI

Rebecca Louise Wiggins, NP

  • Family Nurse Practitioner
  • Traverse City, MI
National Provider Identifier
1033690326
Registry record updated Jun 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704197394 Issued in MI
Practice address
815 Business Park Dr Ste a
Traverse City, MI 49686-8683
Phone
(231) 421-6921
Fax
(231) 421-7852
NPI assigned
Aug 24, 2018
Last updated
Jun 14, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704197394 MI Primary

Addresses

Primary practice location

815 Business Park Dr Ste a
Traverse City, MI 49686-8683

Mailing address

3785 Bay Rd
Saginaw, MI 48603-2433
Phone (989) 791-2455

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address ccm@chronic-care.net Direct
Direct Messaging Address ccm@chronic-care.net Direct
Direct Messaging Address ccm@chronic-care.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20180907000951 MI Practitioner - Nurse Practitioner 2860742178 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Chronic Care Management LLC Nurse Practitioner CurrentSince Aug 1, 2018 Accepting new patients

Locations

204 W Buttles St
Midland, MI 48640

801 Joe Mann Blvd
Ste P-6
Midland, MI 48642

3785 Bay Rd
Saginaw, MI 48603

4020 Copper Vw
Ste 104
Traverse City, MI 49684
Phone (231) 421-6921

810 Business Park Dr
Ste A
Traverse City, MI 49686
Phone (231) 421-6921

815 Business Park Dr
#A
Traverse City, MI 49686
Phone (231) 421-6921

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1535068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1033690326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3785 BAY RD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486032433",
            "telephone_number": "989-791-2455",
            "fax_number": "989-791-1392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 BUSINESS PARK DR STE A",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496868683",
            "telephone_number": "231-421-6921",
            "fax_number": "231-421-7852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIGGINS",
        "first_name": "REBECCA",
        "middle_name": "LOUISE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-24",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704197394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ccm@chronic-care.net",
            "affiliation": "N",
            "endpointDescription": "Chronic Care e-mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "810 Business Park Dr Ste A",
            "city": "Traverse City",
            "state": "MI",
            "country_code": "US",
            "postal_code": "496868683",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ccm@chronic-care.net",
            "affiliation": "N",
            "endpointDescription": "Chronic Care e-mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "e-mail",
            "address_1": "4020 Copper Vw Ste 104",
            "city": "Traverse City",
            "state": "MI",
            "country_code": "US",
            "postal_code": "496847041",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ccm@chronic-care.net",
            "affiliation": "N",
            "endpointDescription": "Chronic Care e-mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "815 Business Park Dr Ste A",
            "city": "Traverse City",
            "state": "MI",
            "country_code": "US",
            "postal_code": "496868683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.