Rebecka F Dinwoodie

Key facts

NPI

1477136190

Entity type

Individual (NPI type 1)

Primary specialty

Speech-Language Pathologist 235Z00000X

License

SLP.0004352 (CO)

Practice address

639 Hathaway St
Fairplay, CO 80440

Phone

(860) 921-7313

NPI assigned

Apr 30, 2021

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 27, 2024.

{
    "created_epoch": "1619740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1477136190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "484 POND RD",
            "city": "WALES",
            "state": "ME",
            "postal_code": "042802520",
            "telephone_number": "860-921-7313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "639 HATHAWAY ST",
            "city": "FAIRPLAY",
            "state": "CO",
            "postal_code": "80440",
            "telephone_number": "860-921-7313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DINWOODIE",
        "first_name": "REBECKA",
        "middle_name": "F",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-30",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CO",
            "license": "SLP.0004352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Fairplay, CO · Speech-Language Pathologist in Colorado