Rebecca J Nickell, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

43043 Issued in CO

Practice address

206 W County Line Rd Ste 300
Highlands Ranch, CO 80129

Phone

(303) 795-5980

Fax

(303) 795-7881

NPI assigned

Apr 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Rebecca J Blake Former name

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Oklahoma State University College of Osteopathic Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Altitude Family and Internal Medicine, LLCGroup PAC ID 7911090865, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Berkley Home Health Home health agency, Aurora, CO, CCN 067407
• AdventHealth Littleton Hospital, Littleton, CO, CCN 060113

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rebeccanickell@clhealth.allscriptsdirect.net

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.

• Altitude Family & Internal Medicine, LLC

  • Primary Care Clinic/Center
  • Littleton, CO
  • NPI 1720269020
  Medicare reassignment Care Compare group NPD

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

• Berkley Home Health Care Systems, LLC

  • Home Health Agency
  • Aurora, CO
  • NPI 1225135403
  Care Compare affiliation
• Portercare Adventist Health System

  dba AdventHealth West Littleton ER

  • Emergency Care Clinic/Center
  • Littleton, CO
  • NPI 1548800154

  Hospital

  Care Compare affiliation
• Portercare Adventist Health System

  dba Adventhealth Littleton

  • General Acute Care Hospital
  • Littleton, CO
  • NPI 1689688988
  Care Compare affiliation
• Portercare Adventist Health System

  dba South Denver Heart Center

  • General Acute Care Hospital
  • Littleton, CO
  • NPI 1720628332
  Care Compare affiliation

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1477516045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13402 W COAL MINE AVE",
            "address_2": "STE 230",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801275407",
            "telephone_number": "303-730-2167",
            "fax_number": "303-996-4820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 W COUNTY LINE RD STE 300",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "80129",
            "telephone_number": "303-795-5980",
            "fax_number": "303-795-7881"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7030 S Yosemite St",
            "address_purpose": "LOCATION",
            "city": "Centennial",
            "state": "CO",
            "postal_code": "801122026",
            "country_code": "US",
            "telephone_number": "303-721-9984",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7030 S Yosemite St",
            "address_purpose": "LOCATION",
            "city": "Centennial",
            "state": "CO",
            "postal_code": "801122026",
            "country_code": "US",
            "telephone_number": "303-721-9984",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICKELL",
        "first_name": "REBECCA",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-06",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "43043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER COMMERCIAL NUMBER",
            "identifier": "020422",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000144571",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEMBER PTAN",
            "identifier": "403385YU8D",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "BLAKE",
            "middle_name": "J",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dawn H Newell, M.D.
• Ruth F Newell
• Katrina Newman, MA, NCC, LPC
• Claire Nguyen, MD
• Tai Nguyen
• Marcin Niedzwiecki, PT
• Christopher Daniel Niehaus, NURSING ASSISTANT
• Gregory Kimball Nielsen
• Margaret J Nikaido, DPT
• Maria Annabelle Escala Nilsson, RN

• Family Medicine Physician in Highlands Ranch, CO
• Providers in Highlands Ranch, CO by specialty
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2021; 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.