Rebecca Renea Sackman, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2020041681 Issued in MO

Practice address

518 Pine St
Steelville, MO 65565-6041

Phone

(573) 775-5838

NPI assigned

Apr 13, 2021

Last updated

Feb 3, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mercy Clinic Springfield Communities

  dba Mercy Clinic Family Medicine-Willow Springs

  • Rural Health Clinic/Center
  • Willow Springs, MO
  • NPI 1972771657

  Family

  Medicare reassignment NPD
• Mercy Clinic Springfield Communities

  • Family Medicine Physician
  • Hollister, MO
  • NPI 1053350454
  NPD

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

{
    "created_epoch": "1618272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643846400000",
    "number": "1194305235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "518 PINE ST",
            "city": "STEELVILLE",
            "state": "MO",
            "postal_code": "655656041",
            "telephone_number": "573-775-5838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "518 PINE ST",
            "city": "STEELVILLE",
            "state": "MO",
            "postal_code": "655656041",
            "telephone_number": "573-775-5838"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "751 Sappington Bridge Rd",
            "address_purpose": "LOCATION",
            "city": "Sullivan",
            "state": "MO",
            "postal_code": "630802354",
            "country_code": "US",
            "telephone_number": "573-860-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "965 Mattox Dr",
            "address_purpose": "LOCATION",
            "city": "Sullivan",
            "state": "MO",
            "postal_code": "630802365",
            "country_code": "US",
            "telephone_number": "573-860-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SACKMAN",
        "first_name": "REBECCA",
        "middle_name": "RENEA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-13",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2020041681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "965 Mattox Dr",
            "city": "Sullivan",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630802365",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "751 Sappington Bridge Rd",
            "city": "Sullivan",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630802354",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Patients First Health Care LLC
• Playful Perspectives Professional Counseling LLC
• Power of Hope Equestrian Center
• Leighanne Marie Price
• Jordan Marie Priest, DNP, FNP-BC
• Eric Richard Sands, RPH
• St Johns Clinic Inc (SJC-Steelville)
• Steelville Ambulance District
• Steelville Community Services Inc. (Gibbs Care Center)
• Steelville Healthcare LLC (Steelville Care & Rehab Center)

• Family Nurse Practitioner in Steelville, MO
• Providers in Steelville, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.