Individual provider Active NPI

Rebecca Susanne Rockers, M.D.

  • Family Medicine Physician
  • South Bend, IN
National Provider Identifier
1598748121
Registry record updated Jun 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01048955A Issued in IN
Practice address
3371 W Cleveland Road Ext Ste 120
South Bend, IN 46628-9780
Phone
(574) 219-6700
Fax
(574) 218-6708
NPI assigned
Nov 29, 2005
Last updated
Jun 18, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01048955A IN Primary

Addresses

Primary practice location

3371 W Cleveland Road Ext Ste 120
South Bend, IN 46628-9780

Mailing address

3371 W Cleveland Road Ext Ste 201
South Bend, IN 46628-9780
Phone (574) 218-6700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220525001993 IN Order and Referring Only - Family PracticePractitioner - Family Practice 5597861591

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01048955AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Everside Health, LLC CurrentSince Jun 15, 2021 Accepting new patients
Everside Health LLC Family Medicine CurrentSince Sep 23, 2021 Accepting new patients

Locations

3371 W Cleveland Road Ext
Ste 120
South Bend, IN 46628
Phone (574) 218-6700

Interoperability endpoints

  • Direct secure messaging: rebecca.rockers.1@14940.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655510400000",
    "number": "1598748121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3371 W CLEVELAND ROAD EXT STE 201",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466289780",
            "telephone_number": "574-218-6700",
            "fax_number": "574-218-6708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3371 W CLEVELAND ROAD EXT STE 120",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466289780",
            "telephone_number": "574-219-6700",
            "fax_number": "574-218-6708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCKERS",
        "first_name": "REBECCA",
        "middle_name": "SUSANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-29",
        "last_updated": "2022-06-18",
        "certification_date": "2022-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01048955A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.