Rebecka Anne Whitehead, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

043.109145 Issued in IL

Practice address

5135 Rockberry Rd
Loves Park, IL 61111-3389

Phone

(608) 295-3662

NPI assigned

Mar 20, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1647734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647734400000",
    "number": "1295484012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5135 ROCKBERRY RD",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611113389",
            "telephone_number": "608-295-3662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5135 ROCKBERRY RD",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611113389",
            "telephone_number": "608-295-3662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITEHEAD",
        "first_name": "REBECKA",
        "middle_name": "ANNE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-20",
        "last_updated": "2022-03-20",
        "certification_date": "2022-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IL",
            "license": "043.109145",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED PRACTICAL NURSE LICENSE",
            "identifier": "043.109145",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jena Kay Webber, LMT
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• Tara White, LCSW
• Whitfield Endodontics P.C.
• Tyler Carrington Whitfield, DDS
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• Donald E Wight, O.D.
• Kyle Edward Wilhite, M.D.

• Licensed Practical Nurse in Loves Park, IL
• Providers in Loves Park, IL by specialty
• Licensed Practical Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2022; 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.