Rebekah J Petty, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

612188 Issued in TX

Practice address

1515 N Town East Blvd
Suite 138-209
Mesquite, TX 75150-4157

Phone

(214) 537-7220

NPI assigned

Jan 3, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1325548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325548800000",
    "number": "1407126865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 N TOWN EAST BLVD",
            "address_2": "SUITE 138-209",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751504157",
            "telephone_number": "214-537-7220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 N TOWN EAST BLVD",
            "address_2": "SUITE 138-209",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751504157",
            "telephone_number": "214-537-7220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "REBEKAH",
        "middle_name": "J",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-03",
        "last_updated": "2012-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "612188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katina Perry, MSW
• Personal Care Products, Inc.
• Rebekah Peters
• Valerie A Peterson, M.D.
• Benjamin Paul Petrinec
• PF Vision, LLC
• Anthony D Pham, DDS
• David T D Pham, APRN-FNP
• Hilary Claire Pham, APRN
• Uyen T Phan, RDH

• Family Nurse Practitioner in Mesquite, TX
• Providers in Mesquite, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2012; 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.