NPIMap

Individual provider Active NPI

Rebekah Michellle Johnson, FNP-BC

  • Family Nurse Practitioner
  • Florence, SC
National Provider Identifier
1770089823
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
12795 Issued in SC
Practice address
1594 Freedom Blvd Ste 102
Florence, SC 29505-6046
Phone
(843) 679-4221
NPI assigned
Apr 5, 2018
Last updated
Oct 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 12795 SC Primary

Addresses

Primary practice location

1594 Freedom Blvd Ste 102
Florence, SC 29505-6046

Mailing address

PO Box 603898
Charlotte, NC 28260-3898
Phone (843) 792-6200

Other identifiers 1

IdentifierTypeStateIssuer
21795OtherSCSC STATE BOARD OF NURSING

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rjohnson260111@direct.musc.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180625001211 SC Practitioner - Nurse Practitioner 0143575696 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Musc Community PhysiciansGroup PAC ID 6507260668, 1,353 clinicians

Practice addresses (Care Compare)

1594 Freedom Blvd
Florence, SC 29505-6046

506 N St
Bamberg, SC 29003-1319
Phone (803) 245-6290

511 S Main St
Mullins, SC 29574-3509
Phone (843) 464-8244

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.41 of 100Reported as group
Quality
64.93
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12795SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Family Care, Inc CurrentSince May 14, 2020 Accepting new patients
Carolina Family Care, Inc CurrentSince May 14, 2020 Accepting new patients
Musc Community Physicians CurrentSince Jan 30, 2022 Accepting new patients
Medical University Hospital Authority Current Accepting new patients
Medical University Hospital Authority CurrentSince Nov 1, 2021 Accepting new patients
Medical University Hospital Authority CurrentSince Nov 1, 2021 Accepting new patients
Musc Community Physicians CurrentSince Jan 30, 2022 Accepting new patients
Medical University Hospital Authority Past Accepting new patients
Bellwood Park Emergency Physicians LLC Past Accepting new patients
Regional Medical Center of Orangeburg and Calhoun Counties Past Accepting new patients

Locations

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

1594 Freedom Blvd
Ste 102
Florence, SC 29505
Phone (843) 667-0816

1341 Old Georgetown Rd
Ste C
Mt Pleasant, SC 29464
Phone (843) 884-2175

511 S Main St
Mullins, SC 29574
Phone (843) 464-8244

Interoperability endpoints

  • Direct secure messaging: rjohnson260111@direct.musc.edu

Organizations & group practices 10

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 9

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": "1522886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1770089823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603898",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282603898",
            "telephone_number": "843-792-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1594 FREEDOM BLVD STE 102",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295056046",
            "telephone_number": "843-679-4221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "REBEKAH",
        "middle_name": "MICHELLLE",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-05",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "12795",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SC STATE BOARD OF NURSING",
            "identifier": "21795",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rjohnson260111@direct.musc.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1594 Freedom Blvd Ste 102",
            "city": "Florence",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295056046",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Florence, SC

Sources for this page

Verify at the official NPI Registry.