NPIMap

Individual provider Active NPI

Rebecca Glenn, LMP

  • Mechanotherapist
  • Battle Ground, WA
National Provider Identifier
1265872667
Registry record updated Jun 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
MechanotherapistTaxonomy code 172M00000X
License
MA 00021731 Issued in WA
Practice address
113 S Parkway Ave
Battle Ground, WA 98604-9294
Phone
(360) 687-1781
NPI assigned
Jun 28, 2013
Last updated
Jun 28, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mechanotherapist 172M00000X MA 00021731 WA Primary

Addresses

Primary practice location

113 S Parkway Ave
Battle Ground, WA 98604-9294

Mailing address

113 S Parkway Ave
Battle Ground, WA 98604-9294
Phone (360) 687-1781

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
MA 00021731WAMDMechanotherapist

Practice roles

OrganizationSpecialtyStatusNew patients
Purple Pear Body Therapy Past Accepting new patients
Balance & Bloom Bodywork LLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1372377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372377600000",
    "number": "1265872667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 S PARKWAY AVE",
            "city": "BATTLE GROUND",
            "state": "WA",
            "postal_code": "986049294",
            "telephone_number": "360-687-1781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 S PARKWAY AVE",
            "city": "BATTLE GROUND",
            "state": "WA",
            "postal_code": "986049294",
            "telephone_number": "360-687-1781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLENN",
        "first_name": "REBECCA",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-28",
        "last_updated": "2013-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172M00000X",
            "taxonomy_group": "",
            "desc": "Mechanotherapist",
            "state": "WA",
            "license": "MA 00021731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Battle Ground, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2013; 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.