Active NPI
Rebecca B Brewer, MD
- Obstetrics & Gynecology Physician
- Bloomington, IN
National Provider Identifier
1174514079
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 01040663A
- Practice address
- 3925 Hagan St
Suite 104
Bloomington, IN 47401-8556 - Phone
- (812) 334-8400
- Fax
- (812) 334-8401
- NPI assigned
- Oct 31, 2005
- Reactivated
- Oct 14, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 01040663A | IN | Primary |
Addresses
Primary practice location
3925 Hagan St
Suite 104
Bloomington, IN 47401-8556
Mailing address
3925 Hagan St
Suite 104
Bloomington, IN 47401-8556
Phone (812) 334-8400
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01040663A | IN | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aegis Women'S Healthcare | Obstetrics & Gynecology | 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 and National Provider Directory roles.
-
- Obstetrics & Gynecology Physician
- Bedford, IN
- NPI 1114057189
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571011200000",
"number": "1174514079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3925 HAGAN ST",
"address_2": "SUITE 104",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474018556",
"telephone_number": "812-334-8400",
"fax_number": "812-334-8401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3925 HAGAN ST",
"address_2": "SUITE 104",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474018556",
"telephone_number": "812-334-8400",
"fax_number": "812-334-8401"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BREWER",
"first_name": "REBECCA",
"middle_name": "B",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-10-31",
"last_updated": "2019-10-14",
"deactivation_date": "2019-09-25",
"reactivation_date": "2019-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "IN",
"license": "01040663A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.