Individual provider Active NPI

Rebecca Marie Rice, LCSW

  • Clinical Social Worker
  • Reedsport, OR
National Provider Identifier
1104124445
Registry record updated Sep 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L6211 Issued in OR
Practice address
620 Ranch Rd
Reedsport, OR 97467-1720
Phone
(541) 271-2163
Fax
(541) 271-4058
NPI assigned
Mar 10, 2011
Last updated
Sep 14, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW-30413 ID
Clinical Social Worker 1041C0700X L6211 OR Primary

Addresses

Primary practice location

620 Ranch Rd
Reedsport, OR 97467-1720

Mailing address

620 Ranch Rd
Reedsport, OR 97467-1720
Phone (541) 271-2163

Other practice location 1

2700 Stewart PKWY
Annex B
Roseburg, OR 97471-1281
Phone (541) 440-3532

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150416000883 OR Practitioner - Clinical Social Worker 6204019854 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
May accept Medicare assignment
Group practices
Waterfall Clinic IncorporatedGroup PAC ID 5698740355, 16 clinicians

Practice addresses (Care Compare)

1890 Waite St
North Bend, OR 97459-1229
Phone (541) 435-7033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-30413IDMDClinical Social Worker
L6211ORMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Bandon Community Health Ctr CurrentSince Oct 8, 2022 Accepting new patients
Bandon Community Health Center Current Accepting new patients
Bandon Community Health Ctr CurrentSince Oct 8, 2022 Accepting new patients
Waterfall Clinic, Incorporated CurrentSince Oct 1, 2024 Accepting new patients
Waterfall Clinic Incorporated CurrentSince Oct 1, 2024 Accepting new patients

Locations

1010 1st St SE
Ste 110
Bandon, OR 97411
Phone 5413472529119

1890 Waite St
Ste 1
North Bend, OR 97459
Phone (541) 435-7033

Organizations & group practices 5

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": "1299715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1104124445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 RANCH RD",
            "city": "REEDSPORT",
            "state": "OR",
            "postal_code": "974671720",
            "telephone_number": "541-271-2163",
            "fax_number": "541-271-4058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 RANCH RD",
            "city": "REEDSPORT",
            "state": "OR",
            "postal_code": "974671720",
            "telephone_number": "541-271-2163",
            "fax_number": "541-271-4058"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2700 Stewart PKWY",
            "address_2": "Annex B",
            "address_purpose": "LOCATION",
            "city": "Roseburg",
            "state": "OR",
            "postal_code": "974711281",
            "country_code": "US",
            "telephone_number": "541-440-3532",
            "fax_number": "541-440-3554",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICE",
        "first_name": "REBECCA",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-10",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-30413",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L6211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reedsport, OR

Sources for this page

Verify at the official NPI Registry.