Rebecca Louise Wydman, PCC-S

Primary specialty

CounselorTaxonomy code 101Y00000X

License

E 0003507 Issued in OH

Practice address

1349 E Stroop Rd
Kettering, OH 45429-4925

Phone

(937) 293-1115

NPI assigned

Oct 19, 2012

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

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• 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 and National Provider Directory roles.

• South Community Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Moraine, OH
  • NPI 1427289818
  Medicare reassignment NPD
• South Community Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Moraine, OH
  • NPI 1639128176
  NPD

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

{
    "created_epoch": "1350604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350604800000",
    "number": "1245583822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3949 ROBERTANN DR",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454201062",
            "telephone_number": "937-219-5439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1349 E STROOP RD",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454294925",
            "telephone_number": "937-293-1115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYDMAN",
        "first_name": "REBECCA",
        "middle_name": "LOUISE",
        "name_prefix": "Mrs.",
        "credential": "PCC-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-19",
        "last_updated": "2012-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "E 0003507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rhonda Wootton, BSN
• Wright State University Dept of Emergency Medicine
• Ariane Nachel Wright
• Magen Wright, SWT, LCCE, CLC
• Roger D Wright, PT
• Lucy Xayathone, CNP
• Ling Xu, MD
• Norman Michael Yaggi, PA C
• Charles Conner Yancey, DO
• Burhan S Yanes, MD

• Counselor in Kettering, OH
• Providers in Kettering, OH by specialty
• Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2012; 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.