Rebecca G Johnson, CNM
Individual provider Active NPI Advanced Practice Midwife · Paducah, KY
NPI 1285957308 · NPPES record last updated Sep 28, 2018
Key facts
- NPI
- 1285957308
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Advanced Practice Midwife 367A00000X
- License
- 3006383 (KY)
- Practice address
- 1532 Lone Oak Rd Ste 245
Paducah, KY 42003-7941 - Phone
- (270) 538-5700
- Fax
- (270) 538-5701
- NPI assigned
- Mar 3, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mercy Health Physicians Kentucky Specialty Care LLC
Practice addresses (Care Compare)
1532 Lone Oak Rd
Suite 245
Paducah, KY 42003-7941
Phone (270) 538-5700
Hospital & facility affiliations
- Mercy Health - Lourdes Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110817000943 | KY | Practitioner - Nurse Practitioner | 0547439093 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Midwife, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3006383 | KY | MD | Advanced Practice Midwife |
| 6383M | KY | MD | Advanced Practice Midwife |
| APN16127 | TN | MD | Advanced Practice Midwife |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Health Physicians Kentucky Specialty Care LLC | Current |
Accepting new patients | |
| Mercy Health Physicians Kentucky Specialty Care LLC | Current |
Accepting new patients | |
| Mercy Health-Lourdes Hospital LLC | Past | Accepting new patients | |
| McKenzie Medical Center | Past | Accepting new patients | |
| McKenzie Medical Center, PC | Past | Accepting new patients | |
| McKenzie Medical Center | Past | Accepting new patients |
Locations
1000 S 12th St
Murray, KY 42071
Phone (270) 759-9200
1532 Lone Oak Rd
Ste 245
Paducah, KY 42003
Phone (270) 538-5537
1532 Lone Oak Rd
Ste 320
Paducah, KY 42003
Phone (270) 415-3830
1530 Lone Oak Rd
Paducah, KY 42003
Phone (270) 444-2444
Interoperability endpoints
- rjohnson510481@direct.bsmhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | 3006383 | KY | |
| Obstetrics & Gynecology Nurse Practitioner | 363LX0001X | 3006383 | KY | |
| Advanced Practice Midwife | 367A00000X | APN16127 | TN | |
| Advanced Practice Midwife | 367A00000X | 6383M | KY | |
| Advanced Practice Midwife | 367A00000X | 3006383 | KY | Yes |
Addresses
Primary practice location
1532 Lone Oak Rd Ste 245
Paducah, KY 42003-7941
Mailing address
1532 Lone Oak Rd Ste 245
Paducah, KY 42003-7941
Phone (270) 538-5700
Other practice location 1
1000 S 12th St
Murray, KY 42071-9303
Phone (270) 767-3149
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100203570 | Other | KY | KY MEDICAID |
| 1525514 | Medicaid | TN | |
| 3380640 | Other | TN | GROUP MEDICAID |
| K009831 | Other | KY | KY MEDICARE PTAN |
| 3380640 | Other | TN | GROP MEDICARE |
Other providers in Paducah, KY
- Benjamin Lee Johnson II
- Carl M Johnson
- Jeff Johnson
- Kierstyn Alexa Johnson
- Paul J Johnson
- Robin Johnson
- Stephanie Johnson
- Tonya Denise Johnson
- Brian S Johnston
- Emily Blythe Johnston
All providers in Paducah, KY · Advanced Practice Midwife in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 28, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.