Bethany Rose Rettberg, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209.010227 Issued in IL

Practice address

11200 Lincoln Hwy
Mokena, IL 60448-8208

Phone

(866) 389-2727

NPI assigned

Mar 11, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Minuteclinic Diagnostic of Illinois PLLCGroup PAC ID 8729171566, 106 clinicians

Minuteclinic Primary Care Illinois PLLCGroup PAC ID 7416471842, 102 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678

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.

• Minuteclinic Diagnostic of Illinois PLLC

  • Family Nurse Practitioner
  • Mokena, IL
  • NPI 1356485809
  Medicare reassignment Care Compare group NPD
• Minuteclinic Primary Care Illinois PLLC

  • Family Nurse Practitioner
  • Mokena, IL
  • NPI 1528875564
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1362960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585612800000",
    "number": "1487995759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11305 ABBEY RD",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604481456",
            "telephone_number": "708-259-9744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11200 LINCOLN HWY",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604488208",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RETTBERG",
        "first_name": "BETHANY",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-11",
        "last_updated": "2020-03-31",
        "certification_date": "2020-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.010227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Mokena, IL
• Providers in Mokena, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.