Rebecca Callie Newton, PA

Individual provider Active NPI Physician Assistant · Wilmore, KY

NPI 1104836089 · NPPES record last updated Aug 23, 2023

Key facts

NPI
1104836089
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
PA188 (KY)
Practice address
100 Veterans Dr
Wilmore, KY 40390-9775
Phone
(859) 858-2814
NPI assigned
Aug 9, 2006
Sex
Female
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20200103000434 KY Order and Referring Only - Physician Assistant 5193776409

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA188KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
New Lexington Clinic, PSC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA188 KY
Physician Assistant 363A00000X PA188 KY Yes

Addresses

Primary practice location

100 Veterans Dr
Wilmore, KY 40390-9775

Mailing address

100 Veterans Dr
Wilmore, KY 40390-9775
Phone (859) 229-6740

Other identifiers

IdentifierTypeStateIssuer
95001889MedicaidKY

Other providers in Wilmore, KY

All providers in Wilmore, KY · Physician Assistant in Kentucky

Sources for this page

Verify at the official NPI Registry.