Active NPI
Rebecca Wong, PHARMD
- Pharmacist
- Crownpoint, NM
National Provider Identifier
1093053274
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28RI03539000
- Practice address
- New Mexico 371
Crownpoint, NM 87313 - Phone
- (505) 786-6344
- NPI assigned
- Jan 23, 2013
- Last updated
- Jan 23, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28RI03539000 | NJ | Primary |
Addresses
Primary practice location
New Mexico 371
Crownpoint, NM 87313
Mailing address
PO Box 358
Crownpoint, NM 87313-0358
Phone (505) 786-6344
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 28RI03539000 | Other | NJ | PHARMACIST LICENSE |
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)
- Enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28RI03539000 | NJ | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1358899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1358899200000",
"number": "1093053274",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 358",
"city": "CROWNPOINT",
"state": "NM",
"postal_code": "873130358",
"telephone_number": "505-786-6344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "NEW MEXICO 371",
"city": "CROWNPOINT",
"state": "NM",
"postal_code": "87313",
"telephone_number": "505-786-6344"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "REBECCA",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-01-23",
"last_updated": "2013-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI03539000",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST LICENSE",
"identifier": "28RI03539000",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Crownpoint, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.