Individual provider Active NPI

Rebekah Stutzman, FNP-C

  • Family Nurse Practitioner
  • Massillon, OH
National Provider Identifier
1598216335
Registry record updated Oct 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN.312002 Issued in OH
Practice address
365 Hamilton Ave NE
Massillon, OH 44646-4015
Phone
(330) 412-0707
NPI assigned
Oct 17, 2016
Last updated
Oct 17, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 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 RN.312002 OH Primary

Addresses

Primary practice location

365 Hamilton Ave NE
Massillon, OH 44646-4015

Mailing address

365 Hamilton Ave NE
Massillon, OH 44646-4015
Phone (330) 412-0707

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20161219002569 OH Practitioner - Nurse Practitioner 2264713882 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wooster Clinic LLCGroup PAC ID 6800708124, 290 clinicians

Practice addresses (Care Compare)

1740 Cleveland Rd
Wooster, OH 44691-2204
Phone (330) 287-4500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN.312002OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wooster Clinic, LLC CurrentSince Oct 15, 2019 Accepting new patients

Locations

1740 Cleveland Rd
Wooster, OH 44691
Phone (330) 287-4500

1761 Beall Ave
Wooster, OH 44691
Phone (330) 263-8100

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1476662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476662400000",
    "number": "1598216335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 HAMILTON AVE NE",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446464015",
            "telephone_number": "330-412-0707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 HAMILTON AVE NE",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446464015",
            "telephone_number": "330-412-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUTZMAN",
        "first_name": "REBEKAH",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-17",
        "last_updated": "2016-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "RN.312002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Massillon, OH

Sources for this page

Verify at the official NPI Registry.