Individual provider Active NPI

Rebecca Leigh Evans, APRN

  • Nurse Practitioner
  • Reno, NV
National Provider Identifier
1700979580
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN000857 Issued in NV
Practice address
1155 Mill St Ms W14
Reno, NV 89502-1576
Phone
(775) 982-7878
Fax
(775) 982-4196
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN33194 NV
Family Nurse Practitioner 363LF0000X APRN000857 NV
Nurse Practitioner 363L00000X APRN000857 NV Primary

Addresses

Primary practice location

1155 Mill St Ms W14
Reno, NV 89502-1576

Mailing address

1155 Mill St Ms M14
Reno, NV 89502-1576
Phone (775) 982-5262

Other identifiers 1

IdentifierTypeStateIssuer
11832664OtherCAQH

Other names 1

  • Rebecca Leigh Grimm Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20130710000279 NV Order and Referring Only - Nurse Practitioner 6406860659

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN33194NVMDRegistered Nurse

Interoperability endpoints

  • Direct secure messaging: revans2247@direct.renown.org

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1700979580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 MILL ST MS M14",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021576",
            "telephone_number": "775-982-5262",
            "fax_number": "775-982-4196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 MILL ST MS W14",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021576",
            "telephone_number": "775-982-7878",
            "fax_number": "775-982-4196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "REBECCA",
        "middle_name": "LEIGH",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NV",
            "license": "RN33194",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "APRN000857",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "APRN000857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11832664",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "GRIMM",
            "middle_name": "LEIGH",
            "credential": "APN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.