Active NPI
Rebecca Lyn Wardlaw, ATC, MA, LAT
- Athletic Trainer
- Omaha, NE
National Provider Identifier
1457590846
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 441
- Practice address
- 12809 W Dodge Rd
Omaha, NE 68154-2155 - Phone
- (402) 206-1945
- NPI assigned
- Feb 9, 2009
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 441 | NE | Primary |
Addresses
Primary practice location
12809 W Dodge Rd
Omaha, NE 68154-2155
Mailing address
13312 Jaynes PLZ Apt 305
Omaha, NE 68164-1059
Phone (402) 499-5260
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
- Credentials
- Master of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1234137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1234137600000",
"number": "1457590846",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13312 JAYNES PLZ APT 305",
"city": "OMAHA",
"state": "NE",
"postal_code": "681641059",
"telephone_number": "402-499-5260"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12809 W DODGE RD",
"city": "OMAHA",
"state": "NE",
"postal_code": "681542155",
"telephone_number": "402-206-1945"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WARDLAW",
"first_name": "REBECCA",
"middle_name": "LYN",
"credential": "ATC, MA, LAT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-02-09",
"last_updated": "2009-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NE",
"license": "441",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.