Individual provider Active NPI

Rebecca Susanne Williamson, NP

  • Family Nurse Practitioner
  • Cape Girardeau, MO
National Provider Identifier
1902316938
Registry record updated Mar 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2017033714 Issued in MO
Practice address
150 S Mount Auburn Rd Ste 342
Cape Girardeau, MO 63703-4911
Phone
(573) 331-5677
Fax
(573) 331-5678
NPI assigned
Oct 4, 2017
Last updated
Mar 3, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209016632 IL
Family Nurse Practitioner 363LF0000X 2017033714 MO Primary

Addresses

Primary practice location

150 S Mount Auburn Rd Ste 342
Cape Girardeau, MO 63703-4911

Mailing address

PO Box 801143
Kansas City, MO 64180-1143
Phone (573) 331-5583

Other practice location 1

305 W Jackson St Ste 103
Carbondale, IL 62901-1474
Phone (618) 351-4972

Other identifiers 1

IdentifierTypeStateIssuer
214881OtherILMULTI SPECIALTY GROUP

Other names 1

  • Rebecca Susanne Thomas Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20171027000082 MO Practitioner - Nurse Practitioner 8022384551 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
67.07 of 100Reported as apm
Quality
85.4
Promoting interoperability
0
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209016632ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Francis Medical Center Current Accepting new patients
Saint Francis Medical Center Family CurrentSince Nov 18, 2017 Accepting new patients
Saint Francis Medical Center CurrentSince Nov 18, 2017 Accepting new patients
Ferguson Medical Group Rural Health Center Inc. Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

150 S Mount Auburn Rd
Ste 320
Cpe Girardeau, MO 63703
Phone (573) 331-5487

150 S Mount Auburn Rd
Ste 342
Cpe Girardeau, MO 63703
Phone (573) 331-5677

211 Saint Francis Dr
Cpe Girardeau, MO 63703
Phone (573) 331-3000

Interoperability endpoints

  • Direct secure messaging: rthomas12459@surescripts.sfmc.net

Organizations & group practices 7

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": "1507075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614729600000",
    "number": "1902316938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 801143",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641801143",
            "telephone_number": "573-331-5583",
            "fax_number": "573-331-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 S MOUNT AUBURN RD STE 342",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637034911",
            "telephone_number": "573-331-5677",
            "fax_number": "573-331-5678"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "305 W Jackson St Ste 103",
            "address_purpose": "LOCATION",
            "city": "Carbondale",
            "state": "IL",
            "postal_code": "629011474",
            "country_code": "US",
            "telephone_number": "618-351-4972",
            "fax_number": "618-351-6522",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "REBECCA",
        "middle_name": "SUSANNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-04",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209016632",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2017033714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTI SPECIALTY GROUP",
            "identifier": "214881",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "THOMAS",
            "middle_name": "SUSANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.