Active NPI
Rebecca G Prim, P.A.
- Physician Assistant
- Tinker AFB, OK
National Provider Identifier
1568648681
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1690
- Practice address
- 7050 Air Depot, BLDG 1094
Tinker AFB, OK 73145-8102 - Phone
- (405) 582-6610
- Fax
- (405) 736-3619
- NPI assigned
- Jan 18, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1690 | OK | Primary |
Addresses
Primary practice location
7050 Air Depot, BLDG 1094
Tinker AFB, OK 73145-8102
Mailing address
7050 Air Depot, BLDG 1094
Apo, AA 73145-8102
Phone (405) 582-6610
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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1690 | OK | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summit Medical Center | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Edmond, OK
- NPI 1356574560
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670198400000",
"number": "1568648681",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "MIL",
"address_1": "7050 AIR DEPOT, BLDG 1094",
"city": "APO",
"state": "AA",
"postal_code": "731458102",
"telephone_number": "405-582-6610",
"fax_number": "405-736-3619"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7050 AIR DEPOT, BLDG 1094",
"city": "TINKER AFB",
"state": "OK",
"postal_code": "731458102",
"telephone_number": "405-582-6610",
"fax_number": "405-736-3619"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRIM",
"first_name": "REBECCA",
"middle_name": "G",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-01-18",
"last_updated": "2022-12-05",
"certification_date": "2022-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OK",
"license": "1690",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tinker AFB, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.