Individual provider Active NPI

Rebecca Anne Fetterer

  • Nurse Practitioner
  • Wisconsin Rapids, WI
National Provider Identifier
1659856375
Registry record updated Sep 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
8728-33 Issued in WI
Practice address
410 Dewey St
Wisconsin Rapids, WI 54494-4715
Phone
(715) 421-7442
NPI assigned
Sep 27, 2018
Last updated
Sep 27, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 8728-33 WI Primary

Addresses

Primary practice location

410 Dewey St
Wisconsin Rapids, WI 54494-4715

Mailing address

410 Dewey St
Wisconsin Rapids, WI 54494-4715

Other names 1

  • Rebecca Anne Buteyn; Devroy Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20181030002415 WI Practitioner - Nurse Practitioner 6103179668 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

410 Dewey St
Wisconsin Rapids, WI 54494-4715
Phone (715) 423-6060

420 Dewey St
Wisconsin Rapids, WI 54494-4714
Phone (715) 422-7750

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.65 of 100Reported as group
Quality
87.9
Promoting interoperability
100
Improvement activities
40
Cost
73.87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8728-33WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Riverview Hospital & Clinics, Inc. CurrentSince Oct 1, 2018 Accepting new patients
Aspirus Riverview Hospital & Clinics, Inc. Current Accepting new patients
Aspirus Riverview Hospital & Clinics, Inc. CurrentSince Oct 1, 2018 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

410 Dewey St
Wisconsin Rapids, WI 54494
Phone (715) 421-5257

420 Dewey St
Wisconsin Rapids, WI 54494
Phone (715) 421-7474

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

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": "1538006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538006400000",
    "number": "1659856375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 DEWEY ST",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544944715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 DEWEY ST",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544944715",
            "telephone_number": "715-421-7442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETTERER",
        "first_name": "REBECCA",
        "middle_name": "ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-27",
        "last_updated": "2018-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "8728-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "BUTEYN; DEVROY",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wisconsin Rapids, WI

Sources for this page

Verify at the official NPI Registry.