Individual provider Active NPI

Rebekah Elizabeth Petty

  • Personal Care Attendant
  • Soldotna, AK
National Provider Identifier
1386239366
Registry record updated Mar 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Personal Care AttendantTaxonomy code 3747P1801X
License
1712359 Issued in AK
Practice address
44661 Sterling Hwy Ste a
Soldotna, AK 99669-7900
Phone
(907) 929-5826
NPI assigned
Mar 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X 1712359 AK Primary

Addresses

Primary practice location

44661 Sterling Hwy Ste a
Soldotna, AK 99669-7900

Mailing address

44661 Sterling Hwy Ste a
Soldotna, AK 99669-7900
Phone (907) 929-5826

Other identifiers 1

IdentifierTypeStateIssuer
1712359MedicaidAK

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Heartsandhandsofcare Direct

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
1712359AKMDPersonal Care Attendant

NPI Registry JSON

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

{
    "created_epoch": "1614643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614643200000",
    "number": "1386239366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44661 STERLING HWY STE A",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697900",
            "telephone_number": "907-929-5826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44661 STERLING HWY STE A",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697900",
            "telephone_number": "907-929-5826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "REBEKAH",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-02",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "AK",
            "license": "1712359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1712359",
            "state": "AK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Heartsandhandsofcare",
            "affiliation": "N",
            "endpointDescription": "Heartsandhandsofcare",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "44661 Sterling Hwy Ste A",
            "city": "Soldotna",
            "state": "AK",
            "country_code": "US",
            "postal_code": "996697900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Soldotna, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2021; 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.