Individual provider Active NPI

Rebecca Dyer Etter, RN

  • Adult Psychiatric/Mental Health Registered Nurse
  • Leesburg, VA
National Provider Identifier
1346463601
Registry record updated Sep 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X
License
0001161488 Issued in VA
Practice address
102 Heritage Way NE
Suite 302
Leesburg, VA 20176-4544
Phone
(703) 771-5100
NPI assigned
Apr 11, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X 0001161488 VA Primary

Addresses

Primary practice location

102 Heritage Way NE
Suite 302
Leesburg, VA 20176-4544

Mailing address

102 Heritage Way NE
Suite 302
Leesburg, VA 20176-4544
Phone (703) 771-5100

Other names 1

  • Becky Etter Other name

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
0001161488VAMDAdult Psychiatric/Mental Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189382400000",
    "number": "1346463601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 HERITAGE WAY NE",
            "address_2": "SUITE 302",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201764544",
            "telephone_number": "703-771-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 HERITAGE WAY NE",
            "address_2": "SUITE 302",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201764544",
            "telephone_number": "703-771-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETTER",
        "first_name": "REBECCA",
        "middle_name": "DYER",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-11",
        "last_updated": "2007-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "VA",
            "license": "0001161488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BECKY",
            "last_name": "ETTER",
            "credential": "RN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Leesburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.