Rebecca Ellen Waters, CMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

Practice address

7807 W Sally CT
Wasilla, AK 99623-9869

Phone

(907) 357-0143

NPI assigned

Jun 27, 2015

Last updated

Jun 27, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Rebecca Ellen Bullard Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1435363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435363200000",
    "number": "1114309036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7807 W SALLY CT",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996239869",
            "telephone_number": "907-357-0143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7807 W SALLY CT",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996239869",
            "telephone_number": "907-357-0143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "REBECCA ELLEN",
        "name_prefix": "Mrs.",
        "credential": "CMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-27",
        "last_updated": "2015-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA ELLEN",
            "last_name": "BULLARD",
            "prefix": "MISS",
            "credential": "CMT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Wasilla Group Home LLC
• Wasilla Internal Medicine LLC
• Wasilla Physical Therapy Inc.
• Georgianna Waterer
• Lisa Lynn Waters, RN
• Catherine M Watkins
• Rebecca Watkins
• Julianne Watson, PT, DPT
• Chloe Eden Wear
• Mark Alan Weaver

• Massage Therapist in Wasilla, AK
• Providers in Wasilla, AK by specialty
• Massage Therapist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2015; 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.