Individual provider Active NPI

Rebecca Rae Engman

  • Peer Specialist
  • Muskogee, OK
National Provider Identifier
1235799156
Registry record updated Jun 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
619 N Main St
Muskogee, OK 74401-4431
Phone
(918) 682-8407
Fax
(918) 683-9484
NPI assigned
Jun 13, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X 37V792360517 OK
Peer Specialist 175T00000X Primary

Addresses

Primary practice location

619 N Main St
Muskogee, OK 74401-4431

Mailing address

619 N Main St
Muskogee, OK 74401-4431
Phone (918) 682-8407

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
37V792360517OKMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1560384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560384000000",
    "number": "1235799156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 N MAIN ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744014431",
            "telephone_number": "918-682-8407",
            "fax_number": "918-683-9484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 N MAIN ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744014431",
            "telephone_number": "918-682-8407",
            "fax_number": "918-683-9484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGMAN",
        "first_name": "REBECCA",
        "middle_name": "RAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-13",
        "last_updated": "2019-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "OK",
            "license": "37V792360517",
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskogee, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2019; 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.