Individual provider Active NPI

Rebecca E Pflughoeft, NP

  • Primary Care Nurse Practitioner
  • Eagle River, WI
National Provider Identifier
1174859342
Registry record updated Jan 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
5015-33 Issued in WI
Practice address
930 E Wall St
Eagle River, WI 54521-9368
Phone
(715) 477-3000
Fax
(715) 477-3100
NPI assigned
Oct 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2021

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5015-33 WI
Registered Nurse 163W00000X 101293-030 WI
Family Nurse Practitioner 363LF0000X 501533 WI
Family Nurse Practitioner 363LF0000X 4704122828 MI
Primary Care Nurse Practitioner 363LP2300X 501533 WI
Primary Care Nurse Practitioner 363LP2300X 5015-33 WI Primary

Addresses

Primary practice location

930 E Wall St
Eagle River, WI 54521-9368

Mailing address

930 E Wall St
Eagle River, WI 54521-9368
Phone (715) 477-3000

Other identifiers 1

IdentifierTypeStateIssuer
FO812263OtherAANP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, WI2 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.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130401000222 MI Practitioner - Nurse Practitioner 4981849601 Reassigns benefits to 2 organizations
I20180301000061 WI Practitioner - Nurse Practitioner 4981849601 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
101293-030WIMDRegistered Nurse
5015-33WIMDFamily Nurse Practitioner
501533WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC Nurse Practitioner CurrentSince Sep 1, 2021 Accepting new patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince Feb 26, 2018 Accepting new patients
Portage Physician Practices Inc CurrentSince Dec 1, 2013 Accepting new patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince Feb 26, 2018 Accepting new patients
Portage Physician Practices Inc CurrentSince Dec 1, 2013 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

500 Campus Dr
Ste 5
Hancock, MI 49930
Phone (906) 483-1700

894 Campus Dr
Ste B
Hancock, MI 49930
Phone (906) 483-1128

13 N Washington St
Ypsilanti, MI 48197
Phone (734) 329-4620

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

930 E Wall St
Eagle River, WI 54521
Phone (715) 477-3000

811 E Washington Ave
Madison, WI 53703
Phone (469) 466-7420

2251 N Shore Dr
Ste 100
Rhinelander, WI 54501
Phone (715) 361-2074

1020 Kabel Ave
Rhinelander, WI 54501
Phone (715) 361-2805

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1256256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1174859342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 E WALL ST",
            "city": "EAGLE RIVER",
            "state": "WI",
            "postal_code": "545219368",
            "telephone_number": "715-477-3000",
            "fax_number": "715-477-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 E WALL ST",
            "city": "EAGLE RIVER",
            "state": "WI",
            "postal_code": "545219368",
            "telephone_number": "715-477-3000",
            "fax_number": "715-477-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFLUGHOEFT",
        "first_name": "REBECCA",
        "middle_name": "E",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-23",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "5015-33",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "101293-030",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "501533",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704122828",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "WI",
            "license": "501533",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "WI",
            "license": "5015-33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AANP",
            "identifier": "FO812263",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle River, WI

Sources for this page

Verify at the official NPI Registry.