Individual provider Active NPI

Rebecca Sue Konn

  • Family Nurse Practitioner
  • Strongsville, OH
National Provider Identifier
1811655012
Registry record updated Oct 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.0032240 Issued in OH
Practice address
19600 Kensington CT
Strongsville, OH 44136-7268
Phone
(440) 823-1343
NPI assigned
Dec 4, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X RN441865 OH
Family Nurse Practitioner 363LF0000X APRN.CNP.0032240 OH Primary

Addresses

Primary practice location

19600 Kensington CT
Strongsville, OH 44136-7268

Mailing address

19600 Kensington CT
Strongsville, OH 44136-7268
Phone (440) 823-1343

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
I20221116001447 OH Practitioner - Nurse Practitioner 5698143022 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN441865OHMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Hometown Urgent Care of Michigan, PC CurrentSince Nov 28, 2022 Accepting new patients
Hometown Urgent Care of Michigan, P.C. CurrentSince Nov 28, 2022 Accepting new patients
Urgent Care Specialists, LLC PastSince Apr 28, 2024 Accepting new patients

Locations

6210 Brandt Pike
Ste 102
Huber Heights, OH 45424
Phone (937) 236-8630

6210 Brandt Pike
Huber Heights, OH 45424
Phone (937) 236-8630

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1638576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1811655012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19600 KENSINGTON CT",
            "city": "STRONGSVILLE",
            "state": "OH",
            "postal_code": "441367268",
            "telephone_number": "440-823-1343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19600 KENSINGTON CT",
            "city": "STRONGSVILLE",
            "state": "OH",
            "postal_code": "441367268",
            "telephone_number": "440-823-1343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONN",
        "first_name": "REBECCA",
        "middle_name": "SUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-04",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": "RN441865",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0032240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Strongsville, OH

Sources for this page

Verify at the official NPI Registry.