Individual provider Active NPI

Rebecca L Cauthen, ACNP

  • Gerontology Nurse Practitioner
  • Madison, MS
National Provider Identifier
1134589930
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
R901830 Issued in MS
Practice address
189 Saddlebrook CV
Madison, MS 39110-6633
Phone
(601) 818-0020
NPI assigned
Mar 7, 2016
Sex
Female
Sole proprietor
No

Organizations & group practices 10

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.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MDB Behavioral Health Services LLC 201 clinicians
Heal All Wound Care LLC 10 clinicians

Practice addresses (Care Compare)

1911 Mission
Vicksburg, MS 39180-3762
Phone (601) 456-2598

209 Front St
Vidalia, LA 71373-2837
Phone (601) 665-4162

660 Lakeland E Dr
Suite 210
Flowood, MS 39232-9777
Phone (601) 665-4162

Merit-based Incentive Payment System (MIPS)

Final score
78.38 of 100Reported as group
Quality
54.22
Promoting interoperability
100
Improvement activities
40
Cost
73.72

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, LA2 enrollments
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.

Medicare enrollment records 2

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20160323000411 MS Practitioner - Nurse Practitioner 9638476484 Reassigns benefits to 6 organizations
I20251028001243 LA Practitioner - Nurse Practitioner 9638476484 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R901830MSMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Revitalize Hydration Therapy, LLC Gerontology CurrentSince Mar 26, 2020 Accepting new patients
Heal All Wound Care LLC CurrentSince Apr 1, 2025 Accepting new patients
Uppal Medical Center LLC CurrentSince Feb 1, 2025 Accepting new patients
Medical Foundation of Central Ms CurrentSince Feb 6, 2023 Accepting new patients
Mississippi Baptist Medical Center, Inc. Current Accepting new patients
Medical Foundation of Central Mississippi, Inc. CurrentSince Feb 6, 2023 Accepting new patients
Mississippi Baptist Medical Center, Inc CurrentSince Feb 6, 2023 Accepting new patients
MDB Behavioral Health Services LLC CurrentSince Feb 1, 2025 Accepting new patients
Mississippi Baptist Medical Center, Inc. CurrentSince Feb 6, 2023 Accepting new patients
Heal All Wound Care LLC PastSince Apr 1, 2025 Accepting new patients

Locations

209 Front St
Vidalia, LA 71373
Phone (318) 336-6500

885 Liberty Rd
Ste 300
Flowood, MS 39232
Phone (601) 213-0069

660 Lakeland East Dr
Ste 210
Flowood, MS 39232
Phone (601) 664-4162

1727 E Union St
Greenville, MS 38703
Phone (662) 332-0373

1225 N State St
Jackson, MS 39202
Phone (601) 292-4261

1151 N State St
Ste 404
Jackson, MS 39202
Phone (601) 292-4261

215 Katherine Dr
#A
Jackson, MS 39232

1225 N State St
Ste 100
Jackson, MS 39202
Phone (601) 360-8067

401 Baptist Dr
Ste 104
Madison, MS 39110
Phone (601) 605-2383

965 Ridge Lake Blvd
Ste 315
Memphis, TN 38120
Phone (877) 348-1281

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X R901830 MS Primary

Addresses

NPPES NPI Registry

Primary practice location

189 Saddlebrook CV
Madison, MS 39110-6633

Mailing address

189 Saddlebrook CV
Madison, MS 39110-6633
Phone (601) 818-0020

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
00757226MedicaidMS

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 9, 2024.

{
    "created_epoch": "1457308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1134589930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 SADDLEBROOK CV",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391106633",
            "telephone_number": "601-818-0020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 SADDLEBROOK CV",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391106633",
            "telephone_number": "601-818-0020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAUTHEN",
        "first_name": "REBECCA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-07",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MS",
            "license": "R901830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00757226",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, MS

Sources for this page

Verify at the official NPI Registry.