Rebecca L Van Pay, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

6679-015 Issued in WI

Practice address

2352 Lineville Rd
Suamico, WI 54313-8862

Phone

(920) 471-4988

NPI assigned

Jul 19, 2011

Last updated

Feb 7, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Rebecca L Reckelberg Former name

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Univeristy Dental LLC

  • Dentist
  • Green Bay, WI
  • NPI 1538232202
  NPD (past)

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

{
    "created_epoch": "1311033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549497600000",
    "number": "1851689244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2352 LINEVILLE RD STE 112",
            "city": "SUAMICO",
            "state": "WI",
            "postal_code": "543138863",
            "telephone_number": "920-471-4988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2352 LINEVILLE RD",
            "city": "SUAMICO",
            "state": "WI",
            "postal_code": "543138862",
            "telephone_number": "920-471-4988"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1833 University Ave",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543023637",
            "country_code": "US",
            "telephone_number": "920-437-7444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN PAY",
        "first_name": "REBECCA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-19",
        "last_updated": "2019-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6679-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "RECKELBERG",
            "middle_name": "L",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Reince Chiropractic LLC
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• Alexander Shutter, DPT
• TRB Cleaning LLC D.B.a Bio-One Green Bay
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• Renee Marie Williams, RN
• Madison Andrea Winchell
• Tricia Lee Zimonick
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• Dentist in Suamico, WI
• Providers in Suamico, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.