Active NPI
Rebekah Beth Ergle, MS, LAT, ATC
- Athletic Trainer
- Fort Pierce, FL
National Provider Identifier
1104343367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AL5390
- Practice address
- 3209 Virginia Ave
Fort Pierce, FL 34981-5596 - Phone
- (772) 462-7895
- NPI assigned
- Aug 28, 2017
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AL5390 | FL | Primary |
Addresses
Primary practice location
3209 Virginia Ave
Fort Pierce, FL 34981-5596
Mailing address
3209 Virginia Ave
Fort Pierce, FL 34981-5596
Phone (772) 462-7895
Other practice location 1
308 Warhawk Way
Monroe, LA 71209
Phone (318) 342-5381
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2000028592 | Other | NATA BOC | |
| AL5390 | Other | FL | STATE OF FLORIDA ATHLETIC TRAINING 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)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AL5390 | FL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578873600000",
"number": "1104343367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3209 VIRGINIA AVE",
"city": "FORT PIERCE",
"state": "FL",
"postal_code": "349815596",
"telephone_number": "772-462-7895"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3209 VIRGINIA AVE",
"city": "FORT PIERCE",
"state": "FL",
"postal_code": "349815596",
"telephone_number": "772-462-7895"
}
],
"practiceLocations": [
{
"address_1": "308 Warhawk Way",
"address_purpose": "LOCATION",
"city": "Monroe",
"state": "LA",
"postal_code": "71209",
"country_code": "US",
"telephone_number": "318-342-5381",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ERGLE",
"first_name": "REBEKAH",
"middle_name": "BETH",
"credential": "MS, LAT, ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-28",
"last_updated": "2020-01-13",
"certification_date": "2020-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "FL",
"license": "AL5390",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATA BOC",
"identifier": "2000028592",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF FLORIDA ATHLETIC TRAINING LICENSE",
"identifier": "AL5390",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Pierce, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.