Active NPI
Rebecca Jane Bedard, ATC
- Surgical Technologist
- Atlanta, GA
National Provider Identifier
1114343605
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Technologist
- License
- 13-0618
- Practice address
- 59 Executive Park S
Suite 1000
Atlanta, GA 30329-2208 - Phone
- (404) 778-7137
- NPI assigned
- Mar 9, 2014
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Other Specialist/Technologist | 246Z00000X | 2000001376 | NE | |
| Surgical Technologist | 246ZS0410X | 13-0618 | NY | Primary |
Addresses
Primary practice location
59 Executive Park S
Suite 1000
Atlanta, GA 30329-2208
Mailing address
1015 Piedmont Ave NE Apt C4
Atlanta, GA 30309-3732
Phone (413) 237-0665
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2000001376 | NE | MD | Other Specialist/Technologist |
| 13-0618 | NY | MD | Surgical Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1394323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1394323200000",
"number": "1114343605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1015 PIEDMONT AVE NE APT C4",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303093732",
"telephone_number": "413-237-0665"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "59 EXECUTIVE PARK S",
"address_2": "SUITE 1000",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303292208",
"telephone_number": "404-778-7137"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEDARD",
"first_name": "REBECCA",
"middle_name": "JANE",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-03-09",
"last_updated": "2014-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "246Z00000X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other",
"state": "NE",
"license": "2000001376",
"primary": false
},
{
"code": "246ZS0410X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Technologist",
"state": "NY",
"license": "13-0618",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.