Individual provider Active NPI

Rebecka Marsh Hermsen, R.D, C.D

  • Registered Dietitian
  • Walla Walla, WA
National Provider Identifier
1104017425
Registry record updated Aug 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DI00000065 Issued in WA
Practice address
Walla Walla County Health Department
310 W. Poplar
Walla Walla, WA 99362-0346
Phone
(509) 524-2670
Fax
(509) 524-2681
NPI assigned
Aug 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DI00000065 WA Primary

Addresses

Primary practice location

Walla Walla County Health Department
310 W. Poplar
Walla Walla, WA 99362-0346

Mailing address

Walla Walla County Health Department
310 W. Poplar
Walla Walla, WA 99362-0346
Phone (509) 524-2670

Other identifiers 1

IdentifierTypeStateIssuer
8275653MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DI00000065WAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
County of Walla Walla Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186272000000",
    "number": "1104017425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "WALLA WALLA COUNTY HEALTH DEPARTMENT",
            "address_2": "310 W. POPLAR",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993620346",
            "telephone_number": "509-524-2670",
            "fax_number": "509-524-2681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WALLA WALLA COUNTY HEALTH DEPARTMENT",
            "address_2": "310 W. POPLAR",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993620346",
            "telephone_number": "509-524-2670",
            "fax_number": "509-524-2681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERMSEN",
        "first_name": "REBECKA",
        "middle_name": "MARSH",
        "credential": "R.D,  C.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-05",
        "last_updated": "2007-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WA",
            "license": "DI00000065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8275653",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Walla Walla, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.