Active NPI
Deborah Rectenwald
- Family Nurse Practitioner
- Charleston, WV
National Provider Identifier
1720487267
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 24450
- Practice address
- 3100 Maccorkle Ave SE
Suite 406
Charleston, WV 25304-1223 - Phone
- (304) 388-3776
- Fax
- (304) 388-6481
- NPI assigned
- Aug 21, 2014
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 24450 | WV | Primary |
Addresses
Primary practice location
3100 Maccorkle Ave SE
Suite 406
Charleston, WV 25304-1223
Mailing address
3100 Maccorkle Ave SE
Suite 406
Charleston, WV 25304-1223
Phone (304) 388-3776
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408579200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1408579200000",
"number": "1720487267",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3100 MACCORKLE AVE SE",
"address_2": "SUITE 406",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253041223",
"telephone_number": "304-388-3776",
"fax_number": "304-388-6481"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 MACCORKLE AVE SE",
"address_2": "SUITE 406",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253041223",
"telephone_number": "304-388-3776",
"fax_number": "304-388-6481"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RECTENWALD",
"first_name": "DEBORAH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-21",
"last_updated": "2014-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WV",
"license": "24450",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charleston, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.