Individual provider Active NPI

Rachel W Prytula, CRNP

  • Acute Care Nurse Practitioner
  • Dothan, AL
National Provider Identifier
1861827941
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1-110591 Issued in AL
Practice address
287 Healthwest Dr
Dothan, AL 36303-2031
Phone
(334) 792-9500
Fax
(334) 793-1815
NPI assigned
Sep 9, 2013
Last updated
Oct 16, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1-110591 AL Primary

Addresses

Primary practice location

287 Healthwest Dr
Dothan, AL 36303-2031

Mailing address

287 Healthwest Dr
Dothan, AL 36303-2031
Phone (334) 792-9500

Other names 1

  • Rachel W Tate Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20131118000641 AL Practitioner - Nurse Practitioner 7012143209 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

287 Healthwest Dr
Dothan, AL 36303-2031
Phone (334) 792-9500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.12 of 100Reported as group
Promoting interoperability
85
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1-110591ALMDAcute Care Nurse Practitioner

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1378684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1861827941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "287 HEALTHWEST DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363032031",
            "telephone_number": "334-792-9500",
            "fax_number": "334-793-1815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "287 HEALTHWEST DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363032031",
            "telephone_number": "334-792-9500",
            "fax_number": "334-793-1815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRYTULA",
        "first_name": "RACHEL",
        "middle_name": "W",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-09",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AL",
            "license": "1-110591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHEL",
            "last_name": "TATE",
            "middle_name": "W",
            "credential": "CRNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.