Individual provider Active NPI

Rebekah Venable, PA-C

  • Family Medicine Physician
  • Centennial, CO
National Provider Identifier
1366084329
Registry record updated Aug 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
PA.0007094 Issued in CO
Practice address
6278 S Troy Cir
Centennial, CO 80111-6422
Phone
(317) 504-5732
NPI assigned
Oct 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X PA.0007094 CO Primary

Addresses

Primary practice location

6278 S Troy Cir
Centennial, CO 80111-6422

Mailing address

2010 Rosette LN
Castle Rock, CO 80104-7321
Phone (317) 504-5732

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
PA.0007094COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Magnificat Family Medicine, LLC Family Medicine PastSince Oct 1, 2019 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1570752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722729600000",
    "number": "1366084329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 ROSETTE LN",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801047321",
            "telephone_number": "317-504-5732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6278 S TROY CIR",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801116422",
            "telephone_number": "317-504-5732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENABLE",
        "first_name": "REBEKAH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-11",
        "last_updated": "2024-08-04",
        "certification_date": "2024-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "PA.0007094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centennial, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2024; 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.