Active NPI
Rebekah Graham Hancock, DMD
- General Practice Dentistry
- Locust Grove, GA
National Provider Identifier
1417440405
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN015671
- Practice address
- 4146 Highway 42
Locust Grove, GA 30248-4106 - Phone
- (229) 251-0541
- NPI assigned
- Jun 13, 2018
- Last updated
- Jun 13, 2018
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN015671 | GA | Primary |
Addresses
Primary practice location
4146 Highway 42
Locust Grove, GA 30248-4106
Mailing address
1582 Thornwick Trce
Stockbridge, GA 30281-9116
Phone (229) 251-0541
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
| License | State | Type | Specialty |
|---|---|---|---|
| DN015671 | GA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528848000000",
"number": "1417440405",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1582 THORNWICK TRCE",
"city": "STOCKBRIDGE",
"state": "GA",
"postal_code": "302819116",
"telephone_number": "229-251-0541"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4146 HIGHWAY 42",
"city": "LOCUST GROVE",
"state": "GA",
"postal_code": "302484106",
"telephone_number": "229-251-0541"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANCOCK",
"first_name": "REBEKAH",
"middle_name": "GRAHAM",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-13",
"last_updated": "2018-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "GA",
"license": "DN015671",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Locust Grove, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.