Individual provider Active NPI

Rebecca Leigh Wise, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Rio Rancho, NM
National Provider Identifier
1700210887
Registry record updated Aug 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
4766 Issued in NM
Practice address
4477 9TH Ave NE
Rio Rancho, NM 87124-5634
Phone
(505) 892-7735
NPI assigned
Aug 26, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 4766 NM Primary

Addresses

Primary practice location

4477 9TH Ave NE
Rio Rancho, NM 87124-5634

Mailing address

8212 Wolverine Dr NW
Albuquerque, NM 87120-5268
Phone (505) 450-6932

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
Master of Science

State licenses

LicenseStateTypeSpecialty
4766NMMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1377475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377475200000",
    "number": "1700210887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8212 WOLVERINE DR NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871205268",
            "telephone_number": "505-450-6932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4477 9TH AVE NE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871245634",
            "telephone_number": "505-892-7735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "REBECCA",
        "middle_name": "LEIGH",
        "name_prefix": "Ms.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-26",
        "last_updated": "2013-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NM",
            "license": "4766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Rancho, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2013; 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.