Individual provider Active NPI

Rebecca Conry

  • Registered Nurse
  • Romeo, MI
National Provider Identifier
1528637147
Registry record updated Jun 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
4704357601 Issued in MI
Practice address
71150 Orchard Crossing LN
Romeo, MI 48065-3644
Phone
(586) 336-0102
Fax
(586) 336-0106
NPI assigned
Jun 18, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704357601 MI Primary

Addresses

Primary practice location

71150 Orchard Crossing LN
Romeo, MI 48065-3644

Mailing address

71150 Orchard Crossing LN
Romeo, MI 48065-3644
Phone (586) 336-0102

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4704357601MIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1623974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623974400000",
    "number": "1528637147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71150 ORCHARD CROSSING LN",
            "city": "ROMEO",
            "state": "MI",
            "postal_code": "480653644",
            "telephone_number": "586-336-0102",
            "fax_number": "586-336-0106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71150 ORCHARD CROSSING LN",
            "city": "ROMEO",
            "state": "MI",
            "postal_code": "480653644",
            "telephone_number": "586-336-0102",
            "fax_number": "586-336-0106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONRY",
        "first_name": "REBECCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-18",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704357601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Romeo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.