Active NPI
Rebecca Lynne Wentworth
- Massage Therapist
- Norcross, GA
National Provider Identifier
1528356573
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- BR009324
- Practice address
- 7050 Jimmy Carter Blvd
Norcross, GA 30092-3257 - Phone
- (770) 364-1857
- NPI assigned
- Jul 12, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | BR009324 | GA | Primary |
Addresses
Primary practice location
7050 Jimmy Carter Blvd
Norcross, GA 30092-3257
Mailing address
5443 Oliver CT NW
Lilburn, GA 30047-5822
Phone (770) 364-1857
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 |
|---|---|---|---|
| BR009324 | GA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1310428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1310428800000",
"number": "1528356573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5443 OLIVER CT NW",
"city": "LILBURN",
"state": "GA",
"postal_code": "300475822",
"telephone_number": "770-364-1857"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7050 JIMMY CARTER BLVD",
"city": "NORCROSS",
"state": "GA",
"postal_code": "300923257",
"telephone_number": "770-364-1857"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WENTWORTH",
"first_name": "REBECCA",
"middle_name": "LYNNE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-07-12",
"last_updated": "2011-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "GA",
"license": "BR009324",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norcross, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.