Individual provider Active NPI

Rebecca Callie Newton, PA

  • Physician Assistant
  • Wilmore, KY
National Provider Identifier
1104836089
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA188 Issued in KY
Practice address
100 Veterans Dr
Wilmore, KY 40390-9775
Phone
(859) 858-2814
NPI assigned
Aug 9, 2006
Last updated
Aug 23, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Specialties & licenses 2

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

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 1

IdentifierTypeStateIssuer
95001889MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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.

Enrollment records 1

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
New Lexington Clinic, PSC 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, 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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1104836089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 VETERANS DR",
            "city": "WILMORE",
            "state": "KY",
            "postal_code": "403909775",
            "telephone_number": "859-229-6740",
            "fax_number": "859-258-4243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 VETERANS DR",
            "city": "WILMORE",
            "state": "KY",
            "postal_code": "403909775",
            "telephone_number": "859-858-2814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWTON",
        "first_name": "REBECCA",
        "middle_name": "CALLIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2023-08-23",
        "certification_date": "2022-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA188",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KY",
            "license": "PA188",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95001889",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmore, KY

Sources for this page

Verify at the official NPI Registry.