Individual provider Active NPI

Rebecca A Vitale, PT

  • Physical Therapist
  • Highland, IL
National Provider Identifier
1164447652
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
15 Apex Dr
Highland, IL 62249-1282
Phone
(618) 651-0444
Fax
(618) 654-5439
NPI assigned
Jul 13, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X IL Primary

Addresses

Primary practice location

15 Apex Dr
Highland, IL 62249-1282

Mailing address

15 Apex Dr
Highland, IL 62249-1282
Phone (618) 651-0444

Other names 1

  • Rebecca A Poirot Former name

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

State licenses

LicenseStateTypeSpecialty
070010164ILMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164447652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 APEX DR",
            "city": "HIGHLAND",
            "state": "IL",
            "postal_code": "622491282",
            "telephone_number": "618-651-0444",
            "fax_number": "618-654-5439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 APEX DR",
            "city": "HIGHLAND",
            "state": "IL",
            "postal_code": "622491282",
            "telephone_number": "618-651-0444",
            "fax_number": "618-654-5439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITALE",
        "first_name": "REBECCA",
        "middle_name": "A",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "POIROT",
            "middle_name": "A",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Highland, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.