Rebecca Jo Anderson, M.S.

Individual provider Active NPI Occupational Therapist · Rexburg, ID

NPI 1861653909 · NPPES record last updated Apr 5, 2019

Key facts

NPI
1861653909
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
OTLP-256 (ID)
Practice address
393 E 2ND N
Rexburg, ID 83440-1605
Phone
(208) 360-8005
Fax
(208) 359-9580
NPI assigned
Jun 20, 2008
Sex
Female
Sole proprietor
Yes

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in ID

Medicare enrollment records

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

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
OTLP-256IDMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
MHD Therapies, PLLC Occupational Therapist Current
since 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

Specialties & licenses

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

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

Other providers in Rexburg, ID

All providers in Rexburg, ID · Occupational Therapist in Idaho

Sources for this page

Verify at the official NPI Registry.