Individual provider Active NPI

Michelle Renee Rebenack, RN

  • General Practice Registered Nurse
  • Westfield, IN
National Provider Identifier
1154027639
Registry record updated Feb 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
28178788A Issued in IN
Practice address
937 E 186TH St
Westfield, IN 46074-7827
Phone
(765) 804-8044
Fax
(855) 225-0295
NPI assigned
Feb 6, 2023
Last updated
Feb 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 28178788A IN Primary

Addresses

Primary practice location

937 E 186TH St
Westfield, IN 46074-7827

Mailing address

937 E 186TH St
Westfield, IN 46074-7827
Phone (765) 804-8044

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
28178788AINMDGeneral Practice Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1675641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1154027639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "937 E 186TH ST",
            "city": "WESTFIELD",
            "state": "IN",
            "postal_code": "460747827",
            "telephone_number": "765-804-8044",
            "fax_number": "855-225-0295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "937 E 186TH ST",
            "city": "WESTFIELD",
            "state": "IN",
            "postal_code": "460747827",
            "telephone_number": "765-804-8044",
            "fax_number": "855-225-0295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REBENACK",
        "first_name": "MICHELLE",
        "middle_name": "RENEE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-06",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "IN",
            "license": "28178788A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westfield, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2023; 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.