NPIMap

Individual provider Active NPI

Rebecka Ann Reatherford, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Pueblo, CO
National Provider Identifier
1053895532
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
APN.0994158-NP Issued in CO
Practice address
902 Lakeview Ave
Pueblo, CO 81004-3597
Phone
(719) 557-5855
Fax
(719) 557-5097
NPI assigned
Sep 20, 2018
Last updated
Mar 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 0994158 CO
Acute Care Nurse Practitioner 363LA2100X APN.0994158-NP CO Primary

Addresses

Primary practice location

902 Lakeview Ave
Pueblo, CO 81004-3597

Mailing address

902 Lakeview Ave
Pueblo, CO 81004-3597
Phone (719) 557-5855

Other practice location 1

1008 Minnequa Ave
Pueblo, CO 81004-3733
Phone (719) 557-5174

Other identifiers 1

IdentifierTypeStateIssuer
9000182390MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210922002424 CO Practitioner - Nurse Practitioner 6406253178 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians

Practice addresses (Care Compare)

4112 Outlook Blvd
Suite 303
Pueblo, CO 81008-1667
Phone (719) 557-8600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.85 of 100Reported as group
Quality
91.15
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
89.06 of 100Reported as group
Quality
89.53
Promoting interoperability
100
Improvement activities
40
Cost
74

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0994158COMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Usacs Observation Medicine Services of Colorado Inc. CurrentSince Jun 10, 2024 Accepting new patients
Usacs of Colorado Inc CurrentSince Sep 1, 2021 Accepting new patients
Catholic Health Initiatives Colorado Current Accepting new patients
Usacs Observation Medicine Services of Colorado Inc. Current Accepting new patients
Usacs Observation Medicine Services of Colorado Inc. CurrentSince Jun 10, 2024 Accepting new patients
Usacs of Colorado Inc CurrentSince Sep 1, 2021 Accepting new patients
Usacs of Colorado, Inc Current Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Jan 1, 2023 Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Jan 1, 2023 Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients
West Two Medical Group, PLLC Family Medicine Past Accepting new patients

Locations

11600 W 2nd Pl
Lakewood, CO 80228
Phone (720) 321-1010

7700 S Broadway
Littleton, CO 80122
Phone (303) 269-4786

1008 Minnequa Ave
Pueblo, CO 81004
Phone (719) 557-5656

4112 Outlook Blvd
Ste 303
Pueblo, CO 81008
Phone (719) 557-8600

902 Lakeview Ave
Pueblo, CO 81004
Phone (719) 557-5855

41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551

Organizations & group practices 11

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": "1537401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1053895532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 LAKEVIEW AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810043597",
            "telephone_number": "719-557-5855",
            "fax_number": "719-557-5097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 LAKEVIEW AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810043597",
            "telephone_number": "719-557-5855",
            "fax_number": "719-557-5097"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1008 Minnequa Ave",
            "address_purpose": "LOCATION",
            "city": "Pueblo",
            "state": "CO",
            "postal_code": "810043733",
            "country_code": "US",
            "telephone_number": "719-557-5174",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REATHERFORD",
        "first_name": "REBECKA",
        "middle_name": "ANN",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-20",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CO",
            "license": "0994158",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CO",
            "license": "APN.0994158-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000182390",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.