Rebecca Jean Smouse, FNP

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

F346365-01 Issued in NY

Practice address

1107 Prendergast Ave
Jamestown, NY 14701-3315

Phone

(716) 450-7672

NPI assigned

Oct 23, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1603411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603411200000",
    "number": "1356940084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 PRENDERGAST AVE",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147013315",
            "telephone_number": "716-450-7672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 PRENDERGAST AVE",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147013315",
            "telephone_number": "716-450-7672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMOUSE",
        "first_name": "REBECCA",
        "middle_name": "JEAN",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-23",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "F346365-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Jamestown",
            "affiliation": "N",
            "address_1": "1107 Prendergast Ave",
            "city": "Jamestown",
            "state": "NY",
            "country_code": "US",
            "postal_code": "147013315",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Geraldine Smith, LPN
• Nichole O Smith
• Rhonda Sue Smith, RN
• Ryan M Smith, LMSW
• Shirley Smith
• Angela M Snow
• Blesilda S So, MD
• George L So, M.D.
• Andrew Soh, MD
• Carlie Jean Soldano, FNP-C

• Family Medicine Physician in Jamestown, NY
• Providers in Jamestown, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2020; 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.