Rebekah Rud

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

10959 Issued in MN

Practice address

Fond Du Lac Human Services Divison
927 Trettel Lane
Cloquet, MN 55720-1345

Phone

(218) 879-1227

NPI assigned

Mar 2, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Group practices

Fond Du Lac Reservation Business CommitteeGroup PAC ID 6608775879, 40 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rebekah.rud.p1@direct.fonddulachsd.nextgenshare.com

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.

• Fond Du Lac Reservation Business Committee

  • Clinic/Center
  • Cloquet, MN
  • NPI 1326053166
  Medicare reassignment Care Compare group NPD
• Fond Du Lac Reservation Business Committee

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Cloquet, MN
  • NPI 1053772087
  NPD

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

{
    "created_epoch": "1614643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1851986970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 12TH ST",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557202320",
            "telephone_number": "218-590-0543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "FOND DU LAC HUMAN SERVICES DIVISON",
            "address_2": "927 TRETTEL LANE",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557201345",
            "telephone_number": "218-879-1227"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "506 12th St",
            "address_purpose": "LOCATION",
            "city": "Cloquet",
            "state": "MN",
            "postal_code": "557202320",
            "country_code": "US",
            "telephone_number": "218-590-0543",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUD",
        "first_name": "REBEKAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-02",
        "last_updated": "2024-01-02",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "R1338373",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "10959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James A Rogers, M.D.
• Rolen Cares, LLC
• Allison Marie Ronning
• Kathryn Dorothy Roufs, DPT
• Russell Rowenhorst, LICSW
• Carrie Beth Rutske, APRN, CNP
• Samentha Kay Sakry, MSW, LGSW
• Allysha Sample
• Jonathan Robert Sande, MD
• Sharlene May Santmyer, MSW, LICSW

• Psychiatric/Mental Health Nurse Practitioner in Cloquet, MN
• Providers in Cloquet, MN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.