Individual provider Active NPI

Rebecca Rachele Harris

  • Behavior Analyst
  • Eagle River, AK
National Provider Identifier
1174014187
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
167814 Issued in AK
Practice address
16941 N Eagle River Loop Rd
Eagle River, AK 99577-7824
Phone
(907) 726-5330
Fax
(907) 726-5366
NPI assigned
May 24, 2018
Last updated
Oct 21, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 167814 AK Primary
Behavior Technician 106S00000X AK

Addresses

Primary practice location

16941 N Eagle River Loop Rd
Eagle River, AK 99577-7824

Mailing address

16941 N Eagle River Loop Rd
Eagle River, AK 99577-7824
Phone (907) 726-5330

Other names 1

  • Rebecca Rachele Lynn 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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
167814AKMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1527120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1174014187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16941 N EAGLE RIVER LOOP RD",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777824",
            "telephone_number": "907-726-5330",
            "fax_number": "907-726-5366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16941 N EAGLE RIVER LOOP RD",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777824",
            "telephone_number": "907-726-5330",
            "fax_number": "907-726-5366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "REBECCA",
        "middle_name": "RACHELE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-24",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "AK",
            "license": "167814",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "AK",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "LYNN",
            "middle_name": "RACHELE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Eagle River, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; 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.