Active NPI
Rebecca J Mader, R.N.
- Registered Nurse
- Gillette, WY
National Provider Identifier
1174867188
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 13435
- Practice address
- 501 South Burma Ave.
Gillette, WY 82716 - Phone
- (307) 688-5002
- Fax
- (307) 688-5069
- NPI assigned
- Nov 15, 2012
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 13435 | WY | Primary |
Addresses
Primary practice location
501 South Burma Ave.
Gillette, WY 82716
Mailing address
P.O. Box 3011
Gillette, WY 82717
Phone (307) 688-5002
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
| License | State | Type | Specialty |
|---|---|---|---|
| 13435 | WY | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1352937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352937600000",
"number": "1174867188",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 3011",
"city": "GILLETTE",
"state": "WY",
"postal_code": "82717",
"telephone_number": "307-688-5002",
"fax_number": "307-688-5069"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 SOUTH BURMA AVE.",
"city": "GILLETTE",
"state": "WY",
"postal_code": "82716",
"telephone_number": "307-688-5002",
"fax_number": "307-688-5069"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MADER",
"first_name": "REBECCA",
"middle_name": "J",
"credential": "R.N.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-11-15",
"last_updated": "2012-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WY",
"license": "13435",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gillette, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.