Active NPI
Rebecca Karen Wilson
- Phlebotomy Technician
- Fort Worth, TX
National Provider Identifier
1609076736
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Phlebotomy Technician
- License
- N/A
- Practice address
- 6464 Brentwood Stair Rd Ste 201
Fort Worth, TX 76112-3242 - Phone
- (817) 496-0095
- NPI assigned
- Jul 18, 2007
- 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 |
|---|---|---|---|---|
| Phlebotomy Technician | 246RP1900X | N/A | Primary |
Addresses
Primary practice location
6464 Brentwood Stair Rd Ste 201
Fort Worth, TX 76112-3242
Mailing address
6464 Brentwood Stair Rd Ste 201
Fort Worth, TX 76112-3242
Phone (817) 496-0095
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": "1184716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184716800000",
"number": "1609076736",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6464 BRENTWOOD STAIR RD STE 201",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761123242",
"telephone_number": "817-496-0095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6464 BRENTWOOD STAIR RD STE 201",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761123242",
"telephone_number": "817-496-0095"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "REBECCA",
"middle_name": "KAREN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-18",
"last_updated": "2007-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "246RP1900X",
"taxonomy_group": "",
"desc": "Technician, Pathology, Phlebotomy",
"state": null,
"license": "N/A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.