Individual provider Active NPI

Rebecca S Jones, LAT, ATC

  • Athletic Trainer
  • Wake Forest, NC
National Provider Identifier
1255562963
Registry record updated Mar 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
0318 Issued in NC
Practice address
420 Stadium Dr
Wake Forest, NC 27587-2520
Phone
(919) 625-1695
NPI assigned
Jul 29, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 0318 NC Primary

Addresses

Primary practice location

420 Stadium Dr
Wake Forest, NC 27587-2520

Mailing address

420 Stadium Dr
Wake Forest, NC 27587-2520
Phone (919) 625-1695

Other practice location 1

2115 S Main St Ste C
Wake Forest, NC 27587-5011
Phone (919) 570-5755

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
0318NCMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1248825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552435200000",
    "number": "1255562963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 STADIUM DR",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275872520",
            "telephone_number": "919-625-1695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 STADIUM DR",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275872520",
            "telephone_number": "919-625-1695"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2115 S Main St Ste C",
            "address_purpose": "LOCATION",
            "city": "Wake Forest",
            "state": "NC",
            "postal_code": "275875011",
            "country_code": "US",
            "telephone_number": "919-570-5755",
            "fax_number": "919-570-5756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "REBECCA",
        "middle_name": "S",
        "credential": "LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-29",
        "last_updated": "2019-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NC",
            "license": "0318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wake Forest, NC

Sources for this page

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