Individual provider Active NPI

Rebecca P Wilkins, F.N.P.

  • Women's Health Nurse Practitioner
  • Elizabethton, TN
National Provider Identifier
1467691857
Registry record updated Mar 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
APN7306 Issued in TN
Practice address
1505 W Elk Ave
Elizabethton, TN 37643-2848
Phone
(423) 543-7919
Fax
(423) 543-5323
NPI assigned
Feb 9, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X APN7306 TN Primary

Addresses

Primary practice location

1505 W Elk Ave
Elizabethton, TN 37643-2848

Mailing address

1505 W Elk Ave
Elizabethton, TN 37643-2848
Phone (423) 543-7919

Other identifiers 1

IdentifierTypeStateIssuer
1529845MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20121008000376 TN Practitioner - Nurse Practitioner 9638328628 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1505 W Elk Ave
Suite 1
Elizabethton, TN 37643-2848
Phone (423) 543-7919

BLDG 52 Lake Dr
Mountain Home, TN 37684-0001
Phone (423) 439-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7306TNMDSpeech-Language Pathologist
APN7306TNMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Education Assistance Corporation CurrentSince Jan 4, 2016 Accepting new patients
First Medical Group Inc Past Accepting new patients

Locations

1505 W Elk Ave
Ste 1
Elizabethton, TN 37643
Phone (423) 543-7919

1505 W Elk Ave
Elizabethton, TN 37643
Phone (423) 543-7919

400 E State of Franklin Rd
Johnson City, TN 37601
Phone (423) 433-6200

222 E Main St
Johnson City, TN 37604
Phone (423) 433-6200

Organizations & group practices 2

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 4

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": "1234137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552867200000",
    "number": "1467691857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 W ELK AVE",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "376432848",
            "telephone_number": "423-543-7919",
            "fax_number": "423-543-5323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 W ELK AVE",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "376432848",
            "telephone_number": "423-543-7919",
            "fax_number": "423-543-5323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINS",
        "first_name": "REBECCA",
        "middle_name": "P",
        "name_prefix": "Ms.",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-09",
        "last_updated": "2019-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "TN",
            "license": "APN7306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1529845",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethton, TN

Sources for this page

Verify at the official NPI Registry.