Individual provider Active NPI

Rebecca Lee Mitcham, AGNP-C, RN

  • Nurse Practitioner
  • Killeen, TX
National Provider Identifier
1881426716
Registry record updated Nov 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1173843 Issued in TX
Practice address
3800 S W S Young Dr Ste 201
Killeen, TX 76542-3340
Phone
(254) 245-9175
NPI assigned
Aug 19, 2024
Last updated
Nov 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1173843 TX Primary
Nurse Practitioner 363L00000X 219787 OK
Nurse Practitioner 363L00000X 244088 MT

Addresses

Primary practice location

3800 S W S Young Dr Ste 201
Killeen, TX 76542-3340

Mailing address

PO Box 11538
Killeen, TX 76547-1538
Phone (254) 245-9175

Other practice location 1

4258 Atkins Rd
Salado, TX 76571-6249
Phone (254) 654-5451

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20241009004292 TX Practitioner - Nurse Practitioner 4688106073 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Pain Associates PLLCGroup PAC ID 6204973894, 33 clinicians

Practice addresses (Care Compare)

3800 S W S Young Dr
Suite 201
Killeen, TX 76542-3340
Phone (254) 245-9175

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
244088MTMDNurse Practitioner
219787OKMDNurse Practitioner
1173843TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Pain Associates PLLC CurrentSince Sep 13, 2024 Accepting new patients
Integrated Pain Associates PLLC CurrentSince Sep 13, 2024 Accepting new patients

Locations

3800 S W S Young Dr
Ste 201
Killeen, TX 76542
Phone (254) 213-0489

Organizations & group practices 2

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 2

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": "1724025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762300800000",
    "number": "1881426716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11538",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765471538",
            "telephone_number": "254-245-9175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 S W S YOUNG DR STE 201",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765423340",
            "telephone_number": "254-245-9175"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4258 Atkins Rd",
            "address_purpose": "LOCATION",
            "city": "Salado",
            "state": "TX",
            "postal_code": "765716249",
            "country_code": "US",
            "telephone_number": "254-654-5451",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MITCHAM",
        "first_name": "REBECCA",
        "middle_name": "LEE",
        "credential": "AGNP-C, RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-19",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1173843",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "219787",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MT",
            "license": "244088",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Killeen, TX

Sources for this page

Verify at the official NPI Registry.