Individual provider Active NPI

Rebecca Jo Anderson, M.S.

  • Occupational Therapist
  • Rexburg, ID
National Provider Identifier
1861653909
Registry record updated Apr 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OTLP-256 Issued in ID
Practice address
393 E 2ND N
Rexburg, ID 83440-1605
Phone
(208) 360-8005
Fax
(208) 359-9580
NPI assigned
Jun 20, 2008
Last updated
Apr 5, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OTLP-256 ID Primary

Addresses

Primary practice location

393 E 2ND N
Rexburg, ID 83440-1605

Mailing address

PO Box 711
Rexburg, ID 83440-0711
Phone (208) 359-9570

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090406000159 ID Practitioner - Occupational Therapist in Private Practice 7113074352 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
OTLP-256IDMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
MHD Therapies, PLLC Occupational Therapist CurrentSince Feb 1, 2017 Accepting new patients

Locations

700 N 2nd St
Ashton, ID 83420
Phone (208) 356-9456

36 Professional Plz
Ste 110
Rexburg, ID 83440
Phone (208) 359-9570

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554422400000",
    "number": "1861653909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 711",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834400711",
            "telephone_number": "208-359-9570",
            "fax_number": "208-359-9580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "393 E 2ND N",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834401605",
            "telephone_number": "208-360-8005",
            "fax_number": "208-359-9580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "REBECCA",
        "middle_name": "JO",
        "credential": "M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-20",
        "last_updated": "2019-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ID",
            "license": "OTLP-256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rexburg, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.