Individual provider Active NPI

Rebecca Ann Johnson, CRNP

  • Adult Health Nurse Practitioner
  • Hagerstown, MD
National Provider Identifier
1639683048
Registry record updated Nov 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
R149871 Issued in MD
Practice address
747 Northern Ave
Hagerstown, MD 21742-2723
Phone
(301) 791-6360
NPI assigned
Nov 21, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X R149871 MD Primary

Addresses

Primary practice location

747 Northern Ave
Hagerstown, MD 21742-2723

Mailing address

9910 Browns Mill Rd
Greencastle, PA 17225-9705
Phone (717) 658-3852

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20180122000367 MD Practitioner - Nurse Practitioner 1557505013 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gilchrist Hospice Care IncGroup PAC ID 2769580422, 52 clinicians

Practice addresses (Care Compare)

6701 N Charles St
Baltamore, MD 21204-6808

Hospital & facility affiliations

  • Gilchrist Hospice Care, Inc Hospice, Hunt Valley, MD, CCN 211526
  • Johns Hopkins Howard County Medical Center Hospital, Columbia, MD, CCN 210048

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R149871MDMDAdult Health Nurse Practitioner

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.

Hospital & facility affiliations 2

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": "1511222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511222400000",
    "number": "1639683048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9910 BROWNS MILL RD",
            "city": "GREENCASTLE",
            "state": "PA",
            "postal_code": "172259705",
            "telephone_number": "717-658-3852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 NORTHERN AVE",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217422723",
            "telephone_number": "301-791-6360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "REBECCA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-21",
        "last_updated": "2017-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R149871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

Verify at the official NPI Registry.