Individual provider Active NPI

Pamela S. Rehurek, ASCP

  • Clinical Medical Laboratory
  • Crow Agency, MT
National Provider Identifier
1184876385
Registry record updated Oct 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
121416 Issued in IA
Practice address
Hwy 212
Crow Agency, MT 59022
Phone
(406) 638-3376
NPI assigned
Oct 21, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 121416 IA Primary
Clinical Medical Laboratory 291U00000X 1009 MT

Addresses

Primary practice location

Hwy 212
Crow Agency, MT 59022

Mailing address

PO Box 7777
Fort Smith, MT 59035-7777
Phone (406) 666-2595

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
1009MTMDChiropractor
121416IAMDClinical Medical Laboratory

NPI Registry JSON

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224547200000",
    "number": "1184876385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7777",
            "city": "FORT SMITH",
            "state": "MT",
            "postal_code": "590357777",
            "telephone_number": "406-666-2595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HWY 212",
            "city": "CROW AGENCY",
            "state": "MT",
            "postal_code": "59022",
            "telephone_number": "406-638-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REHUREK",
        "first_name": "PAMELA",
        "middle_name": "S.",
        "name_prefix": "Mrs.",
        "credential": "ASCP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-21",
        "last_updated": "2008-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "IA",
            "license": "121416",
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MT",
            "license": "1009",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crow Agency, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2008; 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.