Active NPI
Rebecca Tubergen, O.T.
- Occupational Therapist
- Indianapolis, IN
National Provider Identifier
1386677342
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 31002140
- Practice address
- 201 Pennsylvania Pkwy
Ste 100
Indianapolis, IN 46280-1393 - Phone
- (317) 817-1200
- Fax
- (317) 817-1220
- NPI assigned
- Jul 9, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 31002140 | IN | Primary |
Addresses
Primary practice location
201 Pennsylvania Pkwy
Ste 100
Indianapolis, IN 46280-1393
Mailing address
201 Pennsylvania Pkwy
Ste 100
Indianapolis, IN 46280-1393
Phone (317) 817-1200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200396460 | Medicaid | IN |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465171200000",
"number": "1386677342",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 PENNSYLVANIA PKWY",
"address_2": "STE 100",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462801393",
"telephone_number": "317-817-1200",
"fax_number": "317-817-1220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 PENNSYLVANIA PKWY",
"address_2": "STE 100",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462801393",
"telephone_number": "317-817-1200",
"fax_number": "317-817-1220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUBERGEN",
"first_name": "REBECCA",
"credential": "O.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-09",
"last_updated": "2016-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IN",
"license": "31002140",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200396460",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.