NPIMap

Individual provider Active NPI

Rebecca R Wellington, PA-C

  • Physician Assistant
  • Moore, OK
National Provider Identifier
1942218755
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2125 Issued in OK
Practice address
2900 S Telephone Rd
Ste. 250
Moore, OK 73160-2968
Phone
(405) 237-7507
NPI assigned
Aug 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601004125 MI
Physician Assistant 363A00000X 2125 OK Primary

Addresses

Primary practice location

2900 S Telephone Rd
Ste. 250
Moore, OK 73160-2968

Mailing address

2900 S Telephone Rd
Ste. 250
Moore, OK 73160-2968
Phone (810) 280-3297

Other identifiers 1

IdentifierTypeStateIssuer
RW004125OtherMISTATE LISC

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address rwellington186484@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120626000559 OK Practitioner - Physician Assistant 5496733123 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2125OKMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Saints Medical Group, LLC CurrentSince Nov 29, 2016 Accepting new patients
Saints Medical Group, LLC CurrentSince Nov 29, 2016 Accepting new patients
Integris Health Edmond, Inc Past Accepting new patients
Mi Neurosurgery Clinic PC Physician Assistant Past Accepting new patients
Integris Baptist Medical Center Inc Past Accepting new patients
Integris Rural Health Inc Past Accepting new patients
Lsi Houston, PA Past Accepting new patients

Locations

608 NW 9th St
Ste 2200
Oklahoma City, OK 73102
Phone (405) 231-3737

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1942218755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 S TELEPHONE RD",
            "address_2": "STE. 250",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731602968",
            "telephone_number": "810-280-3297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 S TELEPHONE RD",
            "address_2": "STE. 250",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731602968",
            "telephone_number": "405-237-7507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLINGTON",
        "first_name": "REBECCA",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601004125",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "2125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LISC",
            "identifier": "RW004125",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rwellington186484@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "rwellington186484@direct-ehr-ssmhc.com",
            "address_1": "2900 S Telephone Rd",
            "address_2": "Ste. 250",
            "city": "Moore",
            "state": "OK",
            "country_code": "US",
            "postal_code": "731602968",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "2900 S Telephone Rd",
            "address_2": "Ste. 250",
            "city": "Moore",
            "state": "OK",
            "country_code": "US",
            "postal_code": "731602968",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Moore, OK

Sources for this page

Verify at the official NPI Registry.