Individual provider Active NPI

Justina Rae Officer, RN

  • Registered Nurse
  • Huntsville, AL
National Provider Identifier
1619762523
Registry record updated Apr 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
1-190588 Issued in AL
Practice address
2004 Airport Rd SW
Huntsville, AL 35801-5845
Phone
(256) 724-0448
NPI assigned
Apr 11, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1-190588 AL Primary

Addresses

Primary practice location

2004 Airport Rd SW
Huntsville, AL 35801-5845

Mailing address

2004 Airport Rd SW
Huntsville, AL 35801-5845
Phone (256) 724-0448

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
1-190588ALMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1744329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744329600000",
    "number": "1619762523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2004 AIRPORT RD SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358015845",
            "telephone_number": "256-724-0448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2004 AIRPORT RD SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358015845",
            "telephone_number": "256-724-0448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OFFICER",
        "first_name": "JUSTINA",
        "middle_name": "RAE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-11",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-190588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2025; 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.