Individual provider Active NPI

Rachel Lynn Recore, WHNP

  • Women's Health Nurse Practitioner
  • Culver City, CA
National Provider Identifier
1255694204
Registry record updated May 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
421081 Issued in NY
Practice address
3865 Jasmine Ave
Culver City, CA 90232-3105
Phone
(949) 484-9517
NPI assigned
Jun 23, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2024

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 4704378411 MI
Women's Health Nurse Practitioner 363LW0102X APRN03599 RI
Women's Health Nurse Practitioner 363LW0102X 089214-23 NH
Women's Health Nurse Practitioner 363LW0102X CNP221458 ME
Women's Health Nurse Practitioner 363LW0102X 12199 CT
Women's Health Nurse Practitioner 363LW0102X 114703 NE
Women's Health Nurse Practitioner 363LW0102X 421081 NY Primary

Addresses

Primary practice location

3865 Jasmine Ave
Culver City, CA 90232-3105

Mailing address

1214 Huntington St
Watertown, NY 13601-2930
Phone (315) 782-7230

Other practice location 1

22567 Summit Dr Ste A
Watertown, NY 13601-7233
Phone (315) 782-7230

Other identifiers 1

IdentifierTypeStateIssuer
03593744MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20131017000086 NY Practitioner - Nurse Practitioner 5991939480 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12199CTMDWomen's Health Nurse Practitioner
CNP221458MEMDWomen's Health Nurse Practitioner
4704378411MIMDWomen's Health Nurse Practitioner
114703NEMDWomen's Health Nurse Practitioner
089214-23NHMDWomen's Health Nurse Practitioner
APRN03599RIMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central New York Brain & Spine Neurosurgery PLLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: rachel.recore.p2@direct.usppny.nextgenshare.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1340409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1255694204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1214 HUNTINGTON ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136012930",
            "telephone_number": "315-782-7230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3865 JASMINE AVE",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902323105",
            "telephone_number": "949-484-9517"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22567 Summit Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Watertown",
            "state": "NY",
            "postal_code": "136017233",
            "country_code": "US",
            "telephone_number": "315-782-7230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RECORE",
        "first_name": "RACHEL",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-23",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MI",
            "license": "4704378411",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "RI",
            "license": "APRN03599",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NH",
            "license": "089214-23",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "ME",
            "license": "CNP221458",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CT",
            "license": "12199",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NE",
            "license": "114703",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NY",
            "license": "421081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03593744",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Culver City, CA

Sources for this page

Verify at the official NPI Registry.