Individual provider Active NPI

Rebekah B Bogan, FNP

  • Family Nurse Practitioner
  • Cairo, IL
National Provider Identifier
1720330608
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
277001252 Issued in IL
Practice address
13245 Kessler Rd
Cairo, IL 62914-3101
Phone
(618) 734-4400
Fax
(618) 477-8557
NPI assigned
Oct 3, 2012
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209010690 IL
Family Nurse Practitioner 363LF0000X 277001252 IL Primary
Family Nurse Practitioner 363LF0000X 2012033119 MO
Registered Nurse 163W00000X 041407232 IL
Registered Nurse 163W00000X 2009015162 MO

Addresses

Primary practice location

13245 Kessler Rd
Cairo, IL 62914-3101

Mailing address

PO Box 3008
Carbondale, IL 62902-3008
Phone (618) 457-0450

Other identifiers 1

IdentifierTypeStateIssuer
1720330608MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rebekah.bogan.p1@direct.chesi.nextgenshare.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20140320000433 IL Practitioner - Nurse Practitioner 3870729387 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Market St
Pulaski, IL 62976-1000
Phone (618) 342-6767

13245 Kessler Rd
Cairo, IL 62914-3101
Phone (618) 734-4400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041407232ILMDRegistered Nurse
2009015162MOMDRegistered Nurse
277001252ILMDFamily Nurse Practitioner
2012033119MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southernmost Illinois Community Health Improvement Corporation Current Accepting new patients
Community Health & Emergency Services, Inc. PastSince Sep 1, 2013 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: rebekah.bogan.p1@direct.chesi.nextgenshare.com

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 1

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": "1349222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1720330608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3008",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629023008",
            "telephone_number": "618-457-0450",
            "fax_number": "618-734-3566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13245 KESSLER RD",
            "city": "CAIRO",
            "state": "IL",
            "postal_code": "629143101",
            "telephone_number": "618-734-4400",
            "fax_number": "618-477-8557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGAN",
        "first_name": "REBEKAH",
        "middle_name": "B",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-03",
        "last_updated": "2026-09-29",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209010690",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "277001252",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2012033119",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041407232",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2009015162",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720330608",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rebekah.bogan.p1@direct.chesi.nextgenshare.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "13245 Kessler Rd",
            "city": "Cairo",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629143101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cairo, IL

Sources for this page

Verify at the official NPI Registry.