Active NPI
Rebecca Douglas, NP
- Nurse Practitioner
- Kokomo, IN
National Provider Identifier
1144436833
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 71002298A
- Practice address
- 3611 S Reed Rd Ste 213
Kokomo, IN 46902-3828 - Phone
- (765) 864-6767
- Fax
- (765) 864-6768
- NPI assigned
- May 16, 2007
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 71002298A | IN | Primary |
Addresses
Primary practice location
3611 S Reed Rd Ste 213
Kokomo, IN 46902-3828
Mailing address
3611 S Reed Rd Ste 213
Kokomo, IN 46902-3828
Phone (765) 864-6767
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71002298A | IN | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194825600000",
"number": "1144436833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3611 S REED RD STE 213",
"city": "KOKOMO",
"state": "IN",
"postal_code": "469023828",
"telephone_number": "765-864-6767",
"fax_number": "765-864-6768"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3611 S REED RD STE 213",
"city": "KOKOMO",
"state": "IN",
"postal_code": "469023828",
"telephone_number": "765-864-6767",
"fax_number": "765-864-6768"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUGLAS",
"first_name": "REBECCA",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-16",
"last_updated": "2007-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IN",
"license": "71002298A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kokomo, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.