Rea Ellezo McQueen

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

000000 Issued in IN

Practice address

1238 Sylvan Nook Dr
Richmond, IN 47374-1650

Phone

(765) 977-5394

NPI assigned

Oct 7, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Complexcare Medical Group Midwest H PLLCGroup PAC ID 0143737148, 128 clinicians

Theoria MedicalGroup PAC ID 5395098339, 317 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Reid Health Hospital, Richmond, IN, CCN 150048

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Complexcare Medical Group Midwest H PLLC

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1457144933

  IN

  Medicare reassignment Care Compare group NPD
• Theoria Medical

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1609362375

  IN

  Medicare reassignment Care Compare group NPD

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

• Reid Hospital & Health Care Services, Inc

  • General Acute Care Hospital
  • Richmond, IN
  • NPI 1063457380
  Care Compare affiliation

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

{
    "created_epoch": "1633564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633564800000",
    "number": "1871255786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1238 SYLVAN NOOK DR",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473741650",
            "telephone_number": "765-977-5394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1238 SYLVAN NOOK DR",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473741650",
            "telephone_number": "765-977-5394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCQUEEN",
        "first_name": "REA",
        "middle_name": "ELLEZO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-07",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "000000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Renee McKinley, LCSW
• Thomas James McKinney, M.D.
• Nicole Suzanne McLeland, LCSW
• Lawrence Wayne McMillion, D.O.
• Shawn McNabb
• McSherr Inc.
• McSherr Inc.
• McSherr Inc.
• Traci Meador, BCBA
• Cynthia Lynn Meadows

• Family Nurse Practitioner in Richmond, IN
• Providers in Richmond, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2021; 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.