Active NPI
Rebecca Joan McConnell
- Pharmacist
- Susanville, CA
National Provider Identifier
1376162818
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 82209
- Practice address
- 2875 Main St
Susanville, CA 96130-4739 - Phone
- (530) 257-1020
- NPI assigned
- Apr 14, 2020
- Last updated
- Apr 14, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | S024331 | AZ | |
| Pharmacist | 183500000X | 20405 | NV | |
| Pharmacist | 183500000X | 82209 | CA | Primary |
Addresses
Primary practice location
2875 Main St
Susanville, CA 96130-4739
Mailing address
471-250 Emerson Dr
Susanville, CA 96130-5777
Phone (530) 310-5058
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S024331 | AZ | MD | Pharmacist |
| 82209 | CA | MD | Pharmacist |
| 20405 | NV | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
2875 Main St
Susanville, CA 96130
Phone (530) 257-1020
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586822400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586822400000",
"number": "1376162818",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "471-250 EMERSON DR",
"city": "SUSANVILLE",
"state": "CA",
"postal_code": "961305777",
"telephone_number": "530-310-5058"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2875 MAIN ST",
"city": "SUSANVILLE",
"state": "CA",
"postal_code": "961304739",
"telephone_number": "530-257-1020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCONNELL",
"first_name": "REBECCA",
"middle_name": "JOAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-04-14",
"last_updated": "2020-04-14",
"certification_date": "2020-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S024331",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NV",
"license": "20405",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "82209",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Susanville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.