Individual provider Active NPI

Rebecca Marie Thorne, NP

  • Nurse Practitioner
  • Wooster, OH
National Provider Identifier
1699869420
Registry record updated Feb 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
10179 Issued in OH
Practice address
1761 Beall Ave Ste 3B
Wooster, OH 44691-2342
Phone
(330) 202-5676
Fax
(330) 202-5677
NPI assigned
Oct 3, 2006
Last updated
Feb 2, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 10179 OH Primary
Adult Health Nurse Practitioner 363LA2200X 209005088 IL

Addresses

Primary practice location

1761 Beall Ave Ste 3B
Wooster, OH 44691-2342

Mailing address

2505 Happy Valley Rd
Wooster, OH 44691-8566
Phone (773) 573-6420

Other identifiers 1

IdentifierTypeStateIssuer
2893061MedicaidOH

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
I20220128001924 OH Practitioner - Nurse Practitioner 0547341257 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wooster Clinic LLCGroup PAC ID 6800708124, 290 clinicians
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

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

9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-5433

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10179OHMDPhysical Therapist
209005088ILMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Clinical LLC Nurse Practitioner PastSince Oct 8, 2019 Accepting new patients
Paragon Clinical Midwest, LLC Nurse Practitioner Past Accepting new patients
Osf Multi-Specialty Group Past Accepting new patients
Pain Management Institute LLC PastSince Feb 1, 2016 Accepting new patients

Organizations & group practices 6

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1699869420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 HAPPY VALLEY RD",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446918566",
            "telephone_number": "773-573-6420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1761 BEALL AVE STE 3B",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446912342",
            "telephone_number": "330-202-5676",
            "fax_number": "330-202-5677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORNE",
        "first_name": "REBECCA",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "10179",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209005088",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2893061",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wooster, OH

Sources for this page

Verify at the official NPI Registry.