Rebecca McDermondt, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

4704288497 Issued in MI

Practice address

940 E 8TH St
Traverse City, MI 49686-2893

Phone

(231) 922-4810

Fax

(231) 929-0416

NPI assigned

Apr 21, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1461196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461196800000",
    "number": "1124472642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 CASS ST",
            "address_2": "SUITE 2A & 2D",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842589",
            "telephone_number": "231-922-4810",
            "fax_number": "231-943-2590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 E 8TH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496862893",
            "telephone_number": "231-922-4810",
            "fax_number": "231-929-0416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDERMONDT",
        "first_name": "REBECCA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-21",
        "last_updated": "2016-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704288497",
            "primary": true
        },
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "MI",
            "license": "4704288497",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184087272",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629431713",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew T McCoubrey, PA-C
• McCrum Family Chiropractic, PLLC
• Christa Cheri McCrum, D.C.
• Chloressa Ane McCuien
• Alyssa Rose McCully
• Kirsty Luise McDonald Rabb
• Elizabeth Ann McDonald, LPC
• Mandee McDonald, PT
• Meredith L McDonald, PA-C
• James R McDonnell, D.O.

• Registered Nurse in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2016; 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.