Active NPI
Rebecca Russell Wheeler
- Anatomic Pathology & Clinical Pathology Physician
- Pine Bluff, AR
National Provider Identifier
1790727287
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- C8173
- Practice address
- 1600 W 40TH Ave
Pine Bluff, AR 71603-6301 - Phone
- (870) 541-7524
- Fax
- (870) 541-7543
- NPI assigned
- Jun 11, 2006
- 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 |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | C8173 | AR | Primary |
Addresses
Primary practice location
1600 W 40TH Ave
Pine Bluff, AR 71603-6301
Mailing address
1600 W 40TH Ave
Pine Bluff, AR 71603-6301
Phone (870) 541-7524
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 126119001 | Medicaid | AR |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C8173 | AR | MD | Anatomic Pathology & Clinical Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1278460800000",
"number": "1790727287",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 W 40TH AVE",
"city": "PINE BLUFF",
"state": "AR",
"postal_code": "716036301",
"telephone_number": "870-541-7524",
"fax_number": "870-541-7543"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 W 40TH AVE",
"city": "PINE BLUFF",
"state": "AR",
"postal_code": "716036301",
"telephone_number": "870-541-7524",
"fax_number": "870-541-7543"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHEELER",
"first_name": "REBECCA",
"middle_name": "RUSSELL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-11",
"last_updated": "2010-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "AR",
"license": "C8173",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "126119001",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pine Bluff, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.