Active NPI
Rebecca A. Rissler, NNP
- Neonatal Nurse Practitioner
- Portland, OR
National Provider Identifier
1740470897
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal Nurse Practitioner
- License
- 200650047NP
- Practice address
- 2801 N Gantenbein Ave
Nicu
Portland, OR 97227-1623 - Phone
- (503) 413-1864
- Fax
- (503) 413-2589
- NPI assigned
- Jul 25, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal Nurse Practitioner | 363LN0000X | 200650047NP | OR | Primary |
Addresses
Primary practice location
2801 N Gantenbein Ave
Nicu
Portland, OR 97227-1623
Mailing address
2801 N Gantenbein Ave
Nicu
Portland, OR 97227-1623
Phone (503) 413-1864
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 218660 | Medicaid | OR | |
| 9658006 | Medicaid | WA |
Other names 1
- Rebecca A. Tevenan
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200650047NP | OR | MD | Neonatal Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Legacy Salmon Creek Hospital | Past | Accepting new patients |
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.
-
- General Acute Care Hospital
- Vancouver, WA
- NPI 1700809829
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1243382400000",
"number": "1740470897",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2801 N GANTENBEIN AVE",
"address_2": "NICU",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972271623",
"telephone_number": "503-413-1864",
"fax_number": "503-413-2589"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2801 N GANTENBEIN AVE",
"address_2": "NICU",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972271623",
"telephone_number": "503-413-1864",
"fax_number": "503-413-2589"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RISSLER",
"first_name": "REBECCA",
"middle_name": "A.",
"credential": "NNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-25",
"last_updated": "2009-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "363LN0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Neonatal",
"state": "OR",
"license": "200650047NP",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "218660",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9658006",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "REBECCA",
"last_name": "TEVENAN",
"middle_name": "A.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.