Individual provider Active NPI

Rebecca Hermes, CPNP

  • Pediatric Nurse Practitioner
  • Frisco, TX
National Provider Identifier
1679002836
Registry record updated Jun 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
AP132748 Issued in TX
Practice address
3535 Victory Group Way Ste 305
Frisco, TX 75034-6722
Phone
(469) 333-1543
Fax
(877) 878-9118
NPI assigned
Jun 9, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X AP132748 TX Primary

Addresses

Primary practice location

3535 Victory Group Way Ste 305
Frisco, TX 75034-6722

Mailing address

3535 Victory Group Way Ste 305
Frisco, TX 75034-6722
Phone (469) 333-1543

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
Certified Pediatric Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP132748TXMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Shine Pediatrics and Wellness Center P.a. Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

NPI Registry JSON

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

{
    "created_epoch": "1496966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496966400000",
    "number": "1679002836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 VICTORY GROUP WAY STE 305",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750346722",
            "telephone_number": "469-333-1543",
            "fax_number": "877-878-9118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 VICTORY GROUP WAY STE 305",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750346722",
            "telephone_number": "469-333-1543",
            "fax_number": "877-878-9118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERMES",
        "first_name": "REBECCA",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-09",
        "last_updated": "2017-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP132748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.