Individual provider Active NPI

Rebecca Stover, RN, NP-C

  • Family Nurse Practitioner
  • Broken Bow, OK
National Provider Identifier
1477925535
Registry record updated Feb 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0096200 Issued in OK
Practice address
813 Veterans Way
Broken Bow, OK 74728
Phone
(580) 584-6600
Fax
(580) 584-6603
NPI assigned
Oct 28, 2015
Last updated
Feb 5, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0096200 OK Primary

Addresses

Primary practice location

813 Veterans Way
Broken Bow, OK 74728

Mailing address

813 Veterans Way
Broken Bow, OK 74728-0554
Phone (580) 584-6600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20160217001691 OK Practitioner - Nurse Practitioner 2365747060 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

813 Veterans Way
Broken Bow, OK 74728-5510
Phone (580) 584-6600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0096200OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
McCurtain Memorial Medical Management, Inc. Past Accepting new patients
Summit Medical Center Past Accepting new patients

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1445990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454630400000",
    "number": "1477925535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 VETERANS WAY",
            "city": "BROKEN BOW",
            "state": "OK",
            "postal_code": "747280554",
            "telephone_number": "580-584-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 VETERANS WAY",
            "city": "BROKEN BOW",
            "state": "OK",
            "postal_code": "74728",
            "telephone_number": "580-584-6600",
            "fax_number": "580-584-6603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOVER",
        "first_name": "REBECCA",
        "credential": "RN, NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-28",
        "last_updated": "2016-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "0096200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broken Bow, OK

Sources for this page

Verify at the official NPI Registry.