Kelly Nicole Rebkovich

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0102203985 Issued in VA

Practice address

4550 Lee Hwy Ste B
Dublin, VA 24084-3802

Phone

(540) 674-4560

NPI assigned

Apr 20, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Free Clinic of the New River Valley IncGroup PAC ID 5294963666, shared by 4 NPIs, 15 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lewisgale Hospital Pulaski Hospital, Pulaski, VA, CCN 490116
• Carilion New River Valley Medical Center Hospital, Christiansburg, VA, CCN 490042
• Lewisgale Hospital Montgomery Hospital, Blacksburg, VA, CCN 490110
• Carilion Tazewell Community Hospital Hospital, Tazewell, VA, CCN 490117

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kelly.rebkovich@hca6.eclinicaldirectplus.com

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.

• Free Clinic of the New River Valley Inc

  • Federally Qualified Health Center (FQHC)
  • Christiansburg, VA
  • NPI 1043648611
  Medicare reassignment NPD
• Free Clinic of the New River Valley Inc

  • Federally Qualified Health Center (FQHC)
  • Pearisburg, VA
  • NPI 1306273149
  Medicare reassignment NPD
• Free Clinic of the New River Valley Inc.

  • Federally Qualified Health Center (FQHC)
  • Dublin, VA
  • NPI 1548706609
  Medicare reassignment NPD
• Kuumba Community Health & Wellness Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Roanoke, VA
  • NPI 1205815420
  Medicare reassignment NPD
• Free Clinic of the New River Valley, Inc

  • Federally Qualified Health Center (FQHC)
  • Pearisburg, VA
  • NPI 1962163154

  Family Medicine

  NPD
• Kuumba Community Health & Wellness Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Roanoke, VA
  • NPI 1821760265
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Carilion New River Valley Medical Center

  • General Acute Care Hospital
  • Christiansburg, VA
  • NPI 1376536573
  Care Compare affiliation
• Carilion Tazewell Community Hospital

  • General Acute Care Hospital
  • Tazewell, VA
  • NPI 1427040328
  Care Compare affiliation
• Montgomery Regional Hospital Inc

  • General Acute Care Hospital
  • Blacksburg, VA
  • NPI 1275570376
  Care Compare affiliation
• Pulaski Community Hospital Inc

  • General Acute Care Hospital
  • Pulaski, VA
  • NPI 1205882396
  Care Compare affiliation
• Pulaski Community Hospital, Inc.

  • Psychiatric Hospital Unit
  • Pulaski, VA
  • NPI 1477018893
  Care Compare affiliation

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

{
    "created_epoch": "1334880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643587200000",
    "number": "1194082602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "388 BEN BOLT AVE",
            "city": "TAZEWELL",
            "state": "VA",
            "postal_code": "246515386",
            "telephone_number": "276-988-8850",
            "fax_number": "276-988-6050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 LEE HWY STE B",
            "city": "DUBLIN",
            "state": "VA",
            "postal_code": "240843802",
            "telephone_number": "540-674-4560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REBKOVICH",
        "first_name": "KELLY",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-20",
        "last_updated": "2022-01-31",
        "certification_date": "2020-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102203985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "KELLY.REBKOVICH@hca6.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "4550 Lee Hwy Ste B",
            "city": "Dublin",
            "state": "VA",
            "country_code": "US",
            "postal_code": "240843802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Premise Health of Virginia Medical PC
• Lindsay Pugh, OT
• Pulaski Adult Day Service & Fall Prevention Center, Inc.
• Pulaski County Board of Supervisors
• Pulaski Internal Medicine, PC
• River Valley Healthcare Associates, PC
• Randall Gary Samples, MD
• Shannon Setliff
• Erin Shaffer, LCSW
• Cassie Ann Sheffey, FNP

• Family Medicine Physician in Dublin, VA
• Providers in Dublin, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.