Individual provider Active NPI

Rebecca Kleckner

  • Student in an Organized Health Care Education/Training Program
  • Orlando, FL
National Provider Identifier
1538740972
Registry record updated Apr 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
4364 Scorpius Street
Hpa II, Suite 123, Floor 1
Orlando, FL 32816
Phone
(407) 823-5932
NPI assigned
Apr 17, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

4364 Scorpius Street
Hpa II, Suite 123, Floor 1
Orlando, FL 32816

Mailing address

1223 Maumee St
Orlando, FL 32828-5169
Phone (412) 805-7322

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

NPI Registry JSON

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

{
    "created_epoch": "1618617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618617600000",
    "number": "1538740972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1223 MAUMEE ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328285169",
            "telephone_number": "412-805-7322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4364 SCORPIUS STREET",
            "address_2": "HPA II, SUITE 123, FLOOR 1",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32816",
            "telephone_number": "407-823-5932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLECKNER",
        "first_name": "REBECCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-17",
        "last_updated": "2021-04-17",
        "certification_date": "2021-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2021; 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.