Individual provider Active NPI

Rebecca Anne Nilson

  • Critical Care Medicine Registered Nurse
  • New Brockton, AL
National Provider Identifier
1417753880
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Registered NurseTaxonomy code 163WC0200X
License
1-196380 Issued in AL
Practice address
7680 County Road 625
New Brockton, AL 36351-6408
Phone
(912) 856-8565
NPI assigned
Feb 24, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 1-196380 AL Primary

Addresses

Primary practice location

7680 County Road 625
New Brockton, AL 36351-6408

Mailing address

7680 County Road 625
New Brockton, AL 36351-6408
Phone (912) 856-8565

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

LicenseStateTypeSpecialty
1-196380ALMDCritical Care Medicine Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1740355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1417753880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7680 COUNTY ROAD 625",
            "city": "NEW BROCKTON",
            "state": "AL",
            "postal_code": "363516408",
            "telephone_number": "912-856-8565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7680 COUNTY ROAD 625",
            "city": "NEW BROCKTON",
            "state": "AL",
            "postal_code": "363516408",
            "telephone_number": "912-856-8565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NILSON",
        "first_name": "REBECCA",
        "middle_name": "ANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-24",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "AL",
            "license": "1-196380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Brockton, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2025; 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.