Rebecca Lynne Gillispie, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA-832 Issued in ID

Practice address

1551 E Mullan Ave Ste 102
Post Falls, ID 83854-9005

Phone

(208) 262-2328

Fax

(208) 619-5057

NPI assigned

Mar 4, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Rebecca Lynne Jackson Former name

Medicare fee-for-service enrollment

Enrolled in ID

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

Physician Assistant

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Idaho Day Surgery LLCGroup PAC ID 0840101218, 87 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwest Specialty Hospital Hospital, Post Falls, ID, CCN 130066
• Kootenai Health Hospital, Coeur D'Alene, ID, CCN 130049

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• North Idaho Day Surgery LLC

  • General Acute Care Hospital
  • Post Falls, ID
  • NPI 1104824739
  Medicare reassignment Care Compare group
• Shellman Inc PA

  • Physical Therapist
  • Coeur D Alene, ID
  • NPI 1326050253
  NPD
• Kootenai Health, Inc.

  • Psychiatry Physician
  • Coeur D Alene, ID
  • NPI 1174661151
  NPD (past)

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

• Kootenai Health, Inc.

  • General Acute Care Hospital
  • Coeur D Alene, ID
  • NPI 1992798409
  Care Compare affiliation
• North Idaho Day Surgery LLC

  • Multi-Specialty Clinic/Center
  • St Maries, ID
  • NPI 1093674301

  Hospital

  Care Compare affiliation
• North Idaho Day Surgery LLC

  • General Acute Care Hospital
  • Post Falls, ID
  • NPI 1104824739
  Care Compare affiliation
• North Idaho Day Surgery LLC

  • Sleep Medicine (Psychiatry & Neurology) Physician
  • Post Falls, ID
  • NPI 1649123589

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1204588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1952571184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1593 E POLSTON AVE",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838545326",
            "telephone_number": "208-262-2300",
            "fax_number": "208-262-2349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 E MULLAN AVE STE 102",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838549005",
            "telephone_number": "208-262-2328",
            "fax_number": "208-619-5057"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1593 E Polston Ave",
            "address_purpose": "LOCATION",
            "city": "Post Falls",
            "state": "ID",
            "postal_code": "838545326",
            "country_code": "US",
            "telephone_number": "208-262-2300",
            "fax_number": "208-262-2349",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILLISPIE",
        "first_name": "REBECCA",
        "middle_name": "LYNNE",
        "name_prefix": "Mrs.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-04",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA10005348",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "JACKSON",
            "middle_name": "LYNNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lawrence Kay Gibbon, MD
• Ryan Wesley Gibson
• Brittany Cheyenne Gilbert, M.S., CF-SLP
• Michael Erik Gilbert, M.D.
• Alyson Gilbertson
• Stevie Gillmore, RN
• Ann Louise Gittleman, CNS, PHD
• David Michael Glassman, MD
• David William Glenn, MD
• Stephen Philip Gloudeman, DMD

• Physician Assistant in Post Falls, ID
• Providers in Post Falls, ID by specialty
• Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; 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.