Individual provider Active NPI

Rebbecca Oliver, AGACNP

  • Nurse Practitioner
  • Livingston, TX
National Provider Identifier
1043903750
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1123734 Issued in TX
Practice address
1900 N Washington Ave
Livingston, TX 77351-2105
Phone
(936) 327-1015
Fax
(888) 815-1346
NPI assigned
May 30, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1123734 TX Primary

Addresses

Primary practice location

1900 N Washington Ave
Livingston, TX 77351-2105

Mailing address

445 Carolcrest LN Apt 221
Livingston, TX 77351-7805
Phone (936) 215-3392

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240123001832 TX Practitioner - Nurse Practitioner 4486006772 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mediswan LLCGroup PAC ID 9537577788, 3 clinicians

Practice addresses (Care Compare)

1900 N Washington Ave
Livingston, TX 77351-2105
Phone (936) 327-1015

Hospital & facility affiliations

  • CHI St Lukes Health Memorial Livingston Hospital, Livingston, TX, CCN 450395

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1123734TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mediswan LLC CurrentSince Dec 4, 2023 Accepting new patients

Locations

1900 N Washington Ave
Livingston, TX 77351
Phone (832) 271-7664

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EDDFCD
  • FHIR API: https://fhir4.healow.com/fhir/r4/EDDFCD/Endpoint/EDDFCD

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1685404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1043903750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 CAROLCREST LN APT 221",
            "city": "LIVINGSTON",
            "state": "TX",
            "postal_code": "773517805",
            "telephone_number": "936-215-3392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 N WASHINGTON AVE",
            "city": "LIVINGSTON",
            "state": "TX",
            "postal_code": "773512105",
            "telephone_number": "936-327-1015",
            "fax_number": "888-815-1346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "REBBECCA",
        "name_prefix": "Ms.",
        "credential": "AGACNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-30",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1123734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livingston, TX

Sources for this page

Verify at the official NPI Registry.