Individual provider Active NPI

Rebecca Botticelli, M.D.

  • Family Medicine Physician
  • Harrisonburg, VA
National Provider Identifier
1053307074
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101054345 Issued in VA
Practice address
1992 Medical Ave
Harrisonburg, VA 22801-3436
Phone
(540) 437-1296
Fax
(540) 437-1298
NPI assigned
Sep 26, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101054345 VA Primary

Addresses

Primary practice location

1992 Medical Ave
Harrisonburg, VA 22801-3436

Mailing address

1168 Nelson Dr
Harrisonburg, VA 22801-3504

Other identifiers 4

IdentifierTypeStateIssuer
201381302OtherVATAX IDENTIFICATION
7011186OtherVACIGNA
195041OtherVAANTHEM
426034OtherVASOUTHERN HEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101054345VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rockingham Family Physicians Family Medicine Current Accepting new patients
Lidee of Aesthetics and Gynecology, PC Family Medicine Past Accepting new patients

Locations

1751 Erickson Ave
Harrisonburg, VA 22801
Phone (540) 433-3344

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.

NPI Registry JSON

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053307074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1168 NELSON DR",
            "city": "HARRISONBURG",
            "state": "VA",
            "postal_code": "228013504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1992 MEDICAL AVE",
            "city": "HARRISONBURG",
            "state": "VA",
            "postal_code": "228013436",
            "telephone_number": "540-437-1296",
            "fax_number": "540-437-1298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTTICELLI",
        "first_name": "REBECCA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101054345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION",
            "identifier": "201381302",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "7011186",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "195041",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHERN HEALTH",
            "identifier": "426034",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisonburg, VA

Sources for this page

Verify at the official NPI Registry.