NPIMap

Individual provider Active NPI

Rebecca Jo Kebberly, NP

  • Acute Care Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1568091684
Registry record updated Nov 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
26477 Issued in SC
Practice address
121 Park Central Dr Ste 200
Columbia, SC 29203-6476
Phone
(803) 252-9907
Fax
(803) 252-9906
NPI assigned
Apr 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 26477 SC Primary

Addresses

Primary practice location

121 Park Central Dr Ste 200
Columbia, SC 29203-6476

Mailing address

121 Park Central Dr Ste 200
Columbia, SC 29203-6476
Phone (803) 252-9907

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221205003270 SC Practitioner - Nurse Practitioner 3779998604 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbia Nephrology Associates PAGroup PAC ID 9537128533, 33 clinicians

Practice addresses (Care Compare)

121 Park Central Dr
Suite 200
Columbia, SC 29203-6476
Phone (803) 726-2399

Hospital & facility affiliations

  • Lexington Medical Center Hospital, West Columbia, SC, CCN 420073
  • Prisma Health Richland Hospital Hospital, Columbia, SC, CCN 420018
  • Prisma Health Baptist Hospital, Columbia, SC, CCN 420086
  • Musc Health Columbia Medical Center Downtown Hospital, Columbia, SC, CCN 420026

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26477SCMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Nephrology Associates PA CurrentSince Nov 7, 2022 Accepting new patients
Columbia Nephrology Associates PA CurrentSince Nov 7, 2022 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

121 Park Central Dr
Ste 200
Columbia, SC 29203
Phone (803) 252-9907

3630 Sunset Blvd
West Columbia, SC 29169
Phone (803) 779-1420

Interoperability endpoints

  • Direct secure messaging: rkebberly638427@direct.ghs.myhfn.org

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 and National Provider Directory roles.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1585785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1568091684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 PARK CENTRAL DR STE 200",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036476",
            "telephone_number": "803-252-9907",
            "fax_number": "803-252-9906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 PARK CENTRAL DR STE 200",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036476",
            "telephone_number": "803-252-9907",
            "fax_number": "803-252-9906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEBBERLY",
        "first_name": "REBECCA",
        "middle_name": "JO",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-02",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "SC",
            "license": "26477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.