Individual provider Active NPI

Rebecca Rockenhaus, ATC

  • Athletic Trainer
  • Fayetteville, AR
National Provider Identifier
1508423203
Registry record updated May 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
864 Issued in AR
Practice address
4155 N Steele Blvd Ste 80
Fayetteville, AR 72703-5394
Phone
(479) 422-9404
NPI assigned
May 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 864 AR Primary

Addresses

Primary practice location

4155 N Steele Blvd Ste 80
Fayetteville, AR 72703-5394

Mailing address

4155 N Steele Blvd Ste 80
Fayetteville, AR 72703-5394
Phone (479) 422-9404

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

LicenseStateTypeSpecialty
864ARMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Bridges Therapy Group, PLLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1559088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559088000000",
    "number": "1508423203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4155 N STEELE BLVD STE 80",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035394",
            "telephone_number": "479-422-9404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4155 N STEELE BLVD STE 80",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035394",
            "telephone_number": "479-422-9404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCKENHAUS",
        "first_name": "REBECCA",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-29",
        "last_updated": "2019-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "AR",
            "license": "864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2019; 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.