Individual provider Active NPI

Rebecca Karen Wilson

  • Phlebotomy Technician
  • Fort Worth, TX
National Provider Identifier
1609076736
Registry record updated Jul 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Phlebotomy TechnicianTaxonomy code 246RP1900X
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

Updated by the provider on Jul 18, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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.

Verify at the official NPI Registry.