Individual provider Active NPI

Rebecca Yvonne Stacer, RN

  • Registered Nurse
  • Brunswick, OH
National Provider Identifier
1962250175
Registry record updated May 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN.405278 Issued in OH
Practice address
2820 Michael Dr
Brunswick, OH 44212-2353
Phone
(440) 650-8879
NPI assigned
May 11, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.405278 OH Primary

Addresses

Primary practice location

2820 Michael Dr
Brunswick, OH 44212-2353

Mailing address

2820 Michael Dr
Brunswick, OH 44212-2353
Phone (440) 650-8879

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN.405278OHMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1715385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715385600000",
    "number": "1962250175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2820 MICHAEL DR",
            "city": "BRUNSWICK",
            "state": "OH",
            "postal_code": "442122353",
            "telephone_number": "440-650-8879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 MICHAEL DR",
            "city": "BRUNSWICK",
            "state": "OH",
            "postal_code": "442122353",
            "telephone_number": "440-650-8879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACER",
        "first_name": "REBECCA",
        "middle_name": "YVONNE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-11",
        "last_updated": "2024-05-11",
        "certification_date": "2024-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.405278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.