Active NPI
Juan Carlos Rebollo II, CNA
- Nurse's Aide
- Naugatuck, CT
National Provider Identifier
1427338227
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse's Aide
- License
- NA9988812
- Practice address
- 38 Prospect St.
Apartment A6
Naugatuck, CT 06770-3045 - Phone
- (860) 218-7027
- NPI assigned
- Aug 24, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Attendant Care Provider | 3747A0650X | NA9988812 | CT | |
| Nurse's Aide | 376K00000X | NA9988812 | CT | Primary |
Addresses
Primary practice location
38 Prospect St.
Apartment A6
Naugatuck, CT 06770-3045
Mailing address
38 Prospect Street
Apartment A6
Naugatuck, CT 06770-3045
Phone (860) 218-7027
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 |
|---|---|---|---|
| NA9988812 | CT | MD | Attendant Care Provider |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314144000000",
"number": "1427338227",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38 PROSPECT STREET",
"address_2": "APARTMENT A6",
"city": "NAUGATUCK",
"state": "CT",
"postal_code": "067703045",
"telephone_number": "860-218-7027"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "38 PROSPECT ST.",
"address_2": "APARTMENT A6",
"city": "NAUGATUCK",
"state": "CT",
"postal_code": "067703045",
"telephone_number": "860-218-7027"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REBOLLO",
"first_name": "JUAN",
"middle_name": "CARLOS",
"name_prefix": "Mr.",
"name_suffix": "II",
"credential": "CNA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-08-24",
"last_updated": "2011-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "3747A0650X",
"taxonomy_group": "",
"desc": "Technician, Attendant Care Provider",
"state": "CT",
"license": "NA9988812",
"primary": false
},
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "CT",
"license": "NA9988812",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Naugatuck, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.