Individual provider Active NPI

Rebecca Joan Kouma, PA

  • Physician Assistant
  • David City, NE
National Provider Identifier
1114705217
Registry record updated Dec 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2981 Issued in NE
Practice address
336 S 9TH St
David City, NE 68632-2116
Phone
(402) 367-3193
NPI assigned
Sep 19, 2023
Last updated
Dec 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2981 NE Primary

Addresses

Primary practice location

336 S 9TH St
David City, NE 68632-2116

Mailing address

336 S 9TH St
David City, NE 68632-2116
Phone (402) 367-3193

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231018003539 NE Practitioner - Physician Assistant 9638524101 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Butler County Clinic P CGroup PAC ID 2668456245, 7 clinicians

Practice addresses (Care Compare)

336 S 9TH St
David City, NE 68632-2116
Phone (402) 367-3193

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2981NEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Butler County Clinic P C CurrentSince Oct 9, 2023 Accepting new patients
Butler County Health Care Center Physician Assistant CurrentSince Oct 9, 2023 Accepting new patients

Locations

336 S 9th St
David City, NE 68632
Phone (402) 367-3193

372 S 9th St
David City, NE 68632
Phone (402) 367-1200

Organizations & group practices 2

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": "1695081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1114705217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 S 9TH ST",
            "city": "DAVID CITY",
            "state": "NE",
            "postal_code": "686322116",
            "telephone_number": "402-367-3193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "336 S 9TH ST",
            "city": "DAVID CITY",
            "state": "NE",
            "postal_code": "686322116",
            "telephone_number": "402-367-3193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUMA",
        "first_name": "REBECCA",
        "middle_name": "JOAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-19",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "2981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in David City, NE

Sources for this page

Verify at the official NPI Registry.