Individual provider Active NPI

Rebecca Rae Rundquist, LLP

  • Clinical Psychologist
  • Muskegon, MI
National Provider Identifier
1295941979
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301008219 Issued in MI
Practice address
125 E Southern Ave
Muskegon, MI 49442-5041
Phone
(231) 724-3699
Fax
(231) 724-3659
NPI assigned
May 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301008219 MI Primary

Addresses

Primary practice location

125 E Southern Ave
Muskegon, MI 49442-5041

Mailing address

PO Box 5352
North Muskegon, MI 49445-0352
Phone (231) 744-4925

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
6301008219MIMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295941979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5352",
            "city": "NORTH MUSKEGON",
            "state": "MI",
            "postal_code": "494450352",
            "telephone_number": "231-744-4925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 E SOUTHERN AVE",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494425041",
            "telephone_number": "231-724-3699",
            "fax_number": "231-724-3659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUNDQUIST",
        "first_name": "REBECCA",
        "middle_name": "RAE",
        "name_prefix": "Ms.",
        "credential": "LLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301008219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.