NPIMap

Individual provider Active NPI

Rebecca L Jordan, CRNP

  • Family Nurse Practitioner
  • Bellefonte, PA
National Provider Identifier
1437591146
Registry record updated Aug 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP013682 Issued in PA
Practice address
141 Medical Park LN
Bellefonte, PA 16823-9112
Phone
(814) 355-7322
Fax
(814) 355-9604
NPI assigned
Jul 23, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP013682 PA
Family Nurse Practitioner 363LF0000X SP013682 PA Primary

Addresses

Primary practice location

141 Medical Park LN
Bellefonte, PA 16823-9112

Mailing address

141 Medical Park LN
Bellefonte, PA 16823-9112
Phone (814) 355-7322

Other names 1

  • Rebecca Linn Tyson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130827000505 PA Practitioner - Nurse Practitioner 7719120542 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

141 Medical Park LN
Bellefonte, PA 16823-9112
Phone (814) 355-7322

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP013682PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Nurse Practitioner Current Accepting new patients
Geisinger Clinic CurrentSince Nov 4, 2017 Accepting new patients
Mount Nittany Medical Center Health Services Inc Nurse Practitioner CurrentSince Aug 12, 2013 Accepting new patients
Geisinger Clinic Nurse Practitioner CurrentSince Nov 4, 2017 Accepting new patients
Mount Nittany Medical Center Health Services Inc Past Accepting new patients

Locations

141 Medical Park Ln
Bellefonte, PA 16823
Phone (814) 355-7322

224 N Logan Blvd
Ste 220
Burnham, PA 17009
Phone (717) 242-0196

100 N Academy Ave
Danville, PA 17822

2051 S Atherton St
State College, PA 16801
Phone (844) 278-4600

1850 E Park Ave
Ste 201
State College, PA 16803
Phone (814) 234-8800

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1374537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629158400000",
    "number": "1437591146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 MEDICAL PARK LN",
            "city": "BELLEFONTE",
            "state": "PA",
            "postal_code": "168239112",
            "telephone_number": "814-355-7322",
            "fax_number": "814-355-9604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 MEDICAL PARK LN",
            "city": "BELLEFONTE",
            "state": "PA",
            "postal_code": "168239112",
            "telephone_number": "814-355-7322",
            "fax_number": "814-355-9604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "REBECCA",
        "middle_name": "L",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-23",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP013682",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP013682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "TYSON",
            "middle_name": "LINN",
            "credential": "CRNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bellefonte, PA

Sources for this page

Verify at the official NPI Registry.