Individual provider Active NPI

Rebecca Lynn Kruse, APRN

  • Family Nurse Practitioner
  • Rocky Hill, CT
National Provider Identifier
1396089777
Registry record updated Nov 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5136 Issued in CT
Practice address
323 Cromwell Ave
Rocky Hill, CT 06067-1801
Phone
(866) 389-2727
Fax
(401) 652-9787
NPI assigned
Nov 25, 2012
Last updated
Nov 25, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5136 CT Primary

Addresses

Primary practice location

323 Cromwell Ave
Rocky Hill, CT 06067-1801

Mailing address

83 Olive St
Level 2
New Haven, CT 06511-6910
Phone (815) 790-3244

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
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5136CTMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
R Mark Pappas, LLC PastSince Jul 25, 2019 Accepting new patients

Organizations & group practices 1

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": "1353801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353801600000",
    "number": "1396089777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 OLIVE ST",
            "address_2": "LEVEL 2",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065116910",
            "telephone_number": "815-790-3244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 CROMWELL AVE",
            "city": "ROCKY HILL",
            "state": "CT",
            "postal_code": "060671801",
            "telephone_number": "866-389-2727",
            "fax_number": "401-652-9787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUSE",
        "first_name": "REBECCA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-25",
        "last_updated": "2012-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "5136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Hill, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.