Individual provider Active NPI

Rebecca Ann Nelson, CNP

  • Adult Health Nurse Practitioner
  • Fremont, OH
National Provider Identifier
1194060848
Registry record updated Jun 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
CO13970 Issued in OH
Practice address
1479 N River Rd
Fremont, OH 43420-9760
Phone
(419) 355-9440
Fax
(419) 355-9443
NPI assigned
Dec 6, 2012
Last updated
Jun 11, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 229332 OH
Adult Health Nurse Practitioner 363LA2200X CO13970 OH Primary

Addresses

Primary practice location

1479 N River Rd
Fremont, OH 43420-9760

Mailing address

PO Box 378
Sandusky, OH 44871-0378
Phone (419) 609-1112

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20130401000179 OH Practitioner - Nurse Practitioner 4385889096 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northern Ohio Medical Specialists,LLCGroup PAC ID 2769386192, shared by 44 NPIs, 252 clinicians

Practice addresses (Care Compare)

1479 N River Rd
Fremont, OH 43420-9760
Phone (419) 355-9440

2500 W Strub Rd
Suite 120
Sandusky, OH 44870-5390
Phone (419) 502-5932

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
229332OHMDRegistered Nurse
CO13970OHMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Ohio Medical Specialists LLC CurrentSince Jul 6, 2015 Accepting new patients
North Coast Professional Company, LLC CurrentSince Jan 30, 2013 Accepting new patients
Northern Ohio Medical Specialists, LLC CurrentSince Dec 8, 2015 Accepting new patients
North Coast Professional Company, LLC Registered Nurse CurrentSince Jan 30, 2013 Accepting new patients
Northern Ohio Medical Specialists, LLC CurrentSince Jul 6, 2015 Accepting new patients

Locations

1479 N River Rd
Fremont, OH 43420
Phone (419) 355-9440

808 Main St
Huron, OH 44839
Phone (419) 433-6117

292 Benedict Ave
Norwalk, OH 44857
Phone (419) 663-3737

1925 Hayes Ave
Sandusky, OH 44870
Phone (419) 557-5177

2500 W Strub Rd
Ste 120
Sandusky, OH 44870
Phone (419) 502-5932

3004 Hayes Ave
Sandusky, OH 44870
Phone (419) 625-2841

703 Tyler St
Ste 352
Sandusky, OH 44870
Phone (419) 557-6785

Interoperability endpoints

  • Direct secure messaging: rnelson20583@nomshealthcare.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1354752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433980800000",
    "number": "1194060848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 378",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448710378",
            "telephone_number": "419-609-1112",
            "fax_number": "419-609-1123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1479 N RIVER RD",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434209760",
            "telephone_number": "419-355-9440",
            "fax_number": "419-355-9443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "REBECCA",
        "middle_name": "ANN",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-06",
        "last_updated": "2015-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "229332",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "CO13970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, OH

Sources for this page

Verify at the official NPI Registry.