Individual provider Active NPI

Rebecca Elise Murdock, CF-SLP

  • Speech-Language Pathologist
  • Virginia Beach, VA
National Provider Identifier
1073078663
Registry record updated Feb 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2204000224 Issued in VA
Practice address
4870 Haygood Rd Ste 102
Virginia Beach, VA 23455-5300
Phone
(757) 499-1290
NPI assigned
Feb 7, 2019
Last updated
Feb 7, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2204000224 VA Primary

Addresses

Primary practice location

4870 Haygood Rd Ste 102
Virginia Beach, VA 23455-5300

Mailing address

4510 Lee Ave
Virginia Beach, VA 23455-1423
Phone (703) 350-9644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240606002746 VA Practitioner - Qualified Speech Language Pathologist 0648712539 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2204000224VAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Powerback Rehabilitation LLC Speech-Language Pathologist CurrentSince Apr 23, 2024 Accepting new patients
Powerback Rehabilitation LLC Speech-Language Pathologist CurrentSince Apr 23, 2024 Accepting new patients

Locations

101 E State St
Kennett Square, PA 19348
Phone (610) 925-4436

Organizations & group practices 2

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": "1549497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549497600000",
    "number": "1073078663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4510 LEE AVE",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234551423",
            "telephone_number": "703-350-9644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4870 HAYGOOD RD STE 102",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234555300",
            "telephone_number": "757-499-1290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURDOCK",
        "first_name": "REBECCA",
        "middle_name": "ELISE",
        "credential": "CF-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-07",
        "last_updated": "2019-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2204000224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.