Rebecca Vanessa Young, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2013013681 Issued in MO

Practice address

109 E 5TH St
Caruthersville, MO 63830-1417

Phone

(573) 359-9803

Fax

(573) 359-0990

NPI assigned

Aug 29, 2013

Last updated

Mar 12, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Ms. Rebecca Vanessa Robbins Former name

Medicare fee-for-service enrollment

Enrolled in MO

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, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeast Missouri Health NetworkGroup PAC ID 6507818044, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: rebecca.young.1@14764.direct.athenahealth.com

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.

• Southeast Missouri Health Network

  • Federally Qualified Health Center (FQHC)
  • New Madrid, MO
  • NPI 1609095975
  Medicare reassignment Care Compare group
• Scott County Health Dept.

  • Public Health or Welfare Agency
  • Sikeston, MO
  • NPI 1790855617
  NPD (past)
• Southeast Missouri Health Network

  dba Portageville Family Clinic

  • Federally Qualified Health Center (FQHC)
  • Portageville, MO
  • NPI 1780803916
  NPD (past)

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

{
    "created_epoch": "1377734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583971200000",
    "number": "1457785123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6738 STATE HIGHWAY 77",
            "city": "BENTON",
            "state": "MO",
            "postal_code": "637368238",
            "telephone_number": "573-313-2500",
            "fax_number": "573-313-2505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 E 5TH ST",
            "city": "CARUTHERSVILLE",
            "state": "MO",
            "postal_code": "638301417",
            "telephone_number": "573-359-9803",
            "fax_number": "573-359-0990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "REBECCA",
        "middle_name": "VANESSA",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-29",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2005027734",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2013013681",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420009234",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "ROBBINS",
            "middle_name": "VANESSA",
            "prefix": "MS.",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Faith Wilson
• Valerie Journey Womble, LMT, MA, CPHT
• WT Regional Medical Associates (West Tennessee Medical Group Primary Care Caruthersville)
• WT Regional Medical Associates
• Shelby Lynn Yates

• Family Nurse Practitioner in Caruthersville, MO
• Providers in Caruthersville, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2020; 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.