Active NPI
Rebecca Walters, MED ATC
- Athletic Trainer
- Myrtle Beach, SC
National Provider Identifier
1164810057
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 899
- Practice address
- 27 Smith Blvd
Myrtle Beach, SC 29588-6096 - Phone
- (843) 340-4021
- NPI assigned
- Dec 31, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 899 | SC | Primary |
Addresses
Primary practice location
27 Smith Blvd
Myrtle Beach, SC 29588-6096
Mailing address
27 Smith Blvd
Myrtle Beach, SC 29588-6096
Phone (843) 340-4021
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 Education
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1419984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1419984000000",
"number": "1164810057",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27 SMITH BLVD",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295886096",
"telephone_number": "843-340-4021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27 SMITH BLVD",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295886096",
"telephone_number": "843-340-4021"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALTERS",
"first_name": "REBECCA",
"name_prefix": "Mrs.",
"credential": "MED ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-12-31",
"last_updated": "2014-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "SC",
"license": "899",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Myrtle Beach, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 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.