Individual provider Active NPI

Rebecca H. Harris, PT

  • Physical Therapist
  • Stony Brook, NY
National Provider Identifier
1609040682
Registry record updated Apr 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
006829 Issued in NY
Practice address
15 Dogwood Dr
Stony Brook, NY 11790-2115
Phone
(631) 751-8538
Fax
(631) 751-8538
NPI assigned
Apr 21, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 006829 NY Primary

Addresses

Primary practice location

15 Dogwood Dr
Stony Brook, NY 11790-2115

Mailing address

15 Dogwood Dr
Stony Brook, NY 11790-2115
Phone (631) 751-8538

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
006829NYMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1208736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208736000000",
    "number": "1609040682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 DOGWOOD DR",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902115",
            "telephone_number": "631-751-8538",
            "fax_number": "631-751-8538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 DOGWOOD DR",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902115",
            "telephone_number": "631-751-8538",
            "fax_number": "631-751-8538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "REBECCA",
        "middle_name": "H.",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-21",
        "last_updated": "2008-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "006829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2008; 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.