Rebecca E. Raedeke, MD, PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

H4304 Issued in TX

Legal business name

REBECCA E. RAEDEKE, MD, PA

Practice address

3506 21St St
Suite 601
Lubbock, TX 79410-1212

Phone

(806) 722-3610

Fax

(806) 722-3613

NPI assigned

Mar 1, 2008

Last updated

Mar 1, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Rebecca Raedeke, MD

Title

Physician

Phone

(806) 722-3610

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1204329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204329600000",
    "number": "1336319789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3506 21ST ST",
            "address_2": "SUITE 601",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101212",
            "telephone_number": "806-722-3610",
            "fax_number": "806-722-3613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3506 21ST ST",
            "address_2": "SUITE 601",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101212",
            "telephone_number": "806-722-3610",
            "fax_number": "806-722-3613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REBECCA E. RAEDEKE, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-01",
        "last_updated": "2008-03-01",
        "status": "A",
        "authorized_official_last_name": "RAEDEKE",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "806-722-3610",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "H4304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2008; 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.