Rebeccah Jean Centola, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

133853 Issued in AK

Practice address

3455 Rewak Dr Ste 106
Fairbanks, AK 99709-5024

Phone

(907) 457-5322

NPI assigned

Jul 29, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1627516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1700559283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "591 SLATER DR",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997013444",
            "telephone_number": "541-633-0723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3455 REWAK DR STE 106",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997095024",
            "telephone_number": "907-457-5322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CENTOLA",
        "first_name": "REBECCAH",
        "middle_name": "JEAN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-29",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AK",
            "license": "133853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasmine Lanay Patrice Cavitt-Newton
• Molly B Cenker
• Center for Relational Health, PC
• Center for Relational Health, PC
• Taylor Centner
• James A Cerney, DDS
• Violeta Cervantes Vazquez
• Michael Chadwick, MS
• Larry Chalcraft II
• Roberta Champlin

• Physical Therapy Assistant in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Physical Therapy Assistant in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2021; 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.