Rebecca Rose Smith, APRN CNM CDE

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

236017 Issued in CA

Practice address

2701 W 68TH St
3 South
Chicago, IL 60629-1813

Phone

(773) 434-4040

NPI assigned

Jan 2, 2014

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Open Door Community Health Centers

  dba Del Norte Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Crescent City, CA
  • NPI 1497840656
  Medicare reassignment NPD
• Open Door Community Health Centers

  dba Humboldt Open Door Clinic

  • Federally Qualified Health Center (FQHC)
  • Arcata, CA
  • NPI 1255435533
  NPD
• Open Door Community Health Centers

  dba McKinleyville Community Health Center

  • Federally Qualified Health Center (FQHC)
  • McKinleyville, CA
  • NPI 1598858169
  NPD
• Open Door Community Health Centers

  dba Eureka Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Eureka, CA
  • NPI 1669569109
  NPD
• Open Door Community Health Centers

  dba Willow Creek Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Willow Creek, CA
  • NPI 1730330739
  NPD
• Open Door Community Health Centers

  dba Open Door Downtown

  • Federally Qualified Health Center (FQHC)
  • Eureka, CA
  • NPI 1831713452
  NPD

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

{
    "created_epoch": "1388620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658016000000",
    "number": "1982025367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 COLDWATER CANYON AVE",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916055162",
            "telephone_number": "818-763-8836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 W 68TH ST",
            "address_2": "3 SOUTH",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606291813",
            "telephone_number": "773-434-4040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6801 Coldwater Canyon Ave",
            "address_purpose": "LOCATION",
            "city": "North Hollywood",
            "state": "CA",
            "postal_code": "916055162",
            "country_code": "US",
            "telephone_number": "818-763-8836",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "REBECCA",
        "middle_name": "ROSE",
        "credential": "APRN CNM CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-02",
        "last_updated": "2022-07-17",
        "certification_date": "2022-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WW0101X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Women's Health Care, Ambulatory",
            "state": "CA",
            "license": "95182490",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CA",
            "license": "236017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rebecca.smith.p1@direct.eisnerhealth.nextgenshare.com",
            "affiliation": "N",
            "endpointDescription": "NextGenShare, Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1530 S Olive St",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900153023",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Peter A Smith, M.D.
• Pinar Jaclyn Smith, MD
• Rachel Elizabeth Smith, PSYD, MA, NCC
• Rachel M Smith, M.A, CCC-SLP
• Rashad Smith, LPC
• Regina Tucker Smith, MS, OTR/L
• Renata O Smith, PHARM.D.
• Robert Anthony Smith, MLD, LAT, ATC
• Robert Fielding Smith, M.D.
• Robert J Smith, LCSW, CADC

• Advanced Practice Midwife in Chicago, IL
• Providers in Chicago, IL by specialty
• Advanced Practice Midwife in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.