Shobha Rebala, APRN

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

ARNP9179052 Issued in FL

Practice address

2617 Mitcham Dr Ste 102
Tallahassee, FL 32308-5479

Phone

(850) 878-1171

Fax

(850) 942-1291

NPI assigned

Jun 2, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tallahassee Memorial Healthcare IncGroup PAC ID 6103724778, 498 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: srebala21664@tallahasseememorial.direct-ci.com

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.

• Tallahassee Memorial Healthcare Inc

  • General Acute Care Hospital
  • Tallahassee, FL
  • NPI 1437177664
  Medicare reassignment Care Compare group NPD
• Brevard Health Center PL

  • Internal Medicine Physician
  • Melbourne, FL
  • NPI 1215254073
  Medicare reassignment NPD
• Tallahassee Memorial Healthcare Inc

  • Family Medicine Physician
  • Tallahassee, FL
  • NPI 1366293102
  NPD
• Tallahassee Memorial Healthcare Inc

  • Pulmonary Disease Physician
  • Tallahassee, FL
  • NPI 1841701729
  NPD

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

{
    "created_epoch": "1433203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574985600000",
    "number": "1457731663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2617 MITCHAM DR STE 102",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085479",
            "telephone_number": "850-878-1171",
            "fax_number": "850-942-1291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2617 MITCHAM DR STE 102",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085479",
            "telephone_number": "850-878-1171",
            "fax_number": "850-942-1291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REBALA",
        "first_name": "SHOBHA",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-02",
        "last_updated": "2019-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SG0600X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Gerontology",
            "state": "FL",
            "license": "ARNP9179052",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP9179052",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "ARNP9179052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018671700",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060754100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Hershberger Reams, RDH
• Reather'S Gentle Touch Loving Care Services LLC
• Rylee Reatherford
• Naila Fahari Reaves-Sanchez
• Kiana Reaves
• Recover. Restart. Refreshed, Inc.
• Red Hills Counseling Center, Inc.
• Red Hills Dental Associates
• Red Hills Oral and Facial Surgery, PA
• Red Hills Surgical Center, LLC

• Primary Care Nurse Practitioner in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Primary Care Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.