Rebecca J. King Rackley, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4579 Issued in OK

Practice address

1201 N Stonewall Ave
Oklahoma City, OK 73117-1214

Phone

(405) 271-5579

NPI assigned

Aug 18, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Variety Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Norman, OK
  • NPI 1427228352
  NPD
• Variety Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Oklahoma City, OK
  • NPI 1780697813
  NPD
• Variety Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Oklahoma City, OK
  • NPI 1942045455
  NPD
• Ou Childrens Physicians Dental Service-Oucp Dental Service

  • General Practice Dentistry
  • Oklahoma City, OK
  • NPI 1013938117
  NPD (past)

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561939200000",
    "number": "1790899474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 N STONEWALL AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731171214",
            "telephone_number": "405-271-5579",
            "fax_number": "405-271-4055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 N STONEWALL AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731171214",
            "telephone_number": "405-271-5579"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 N. Phillips Ave.",
            "address_2": "Suite 8900",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "73104",
            "country_code": "US",
            "telephone_number": "405-271-4750",
            "fax_number": "405-271-4055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KING RACKLEY",
        "first_name": "REBECCA",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2019-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "4579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100826780C",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Rebecca-kingrackley@ouhsc.edu",
            "affiliation": "N",
            "endpointDescription": "University email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1200 N. Phillips Ave.",
            "address_2": "Suite 8900",
            "city": "Oklahoma City",
            "state": "OK",
            "country_code": "US",
            "postal_code": "73104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Koal Kinder, PHARMD
• Karen Annette Kindley, M.D.
• Kindred Hospitals East, LLC
• Roderick Kindred
• Kinex Medical Company, LLC
• Dahn King-Elam, OTR/L
• Mardell King-Hawkins
• Aaron B King
• Angela King
• Arvin C King Jr.

• General Practice Dentistry in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• General Practice Dentistry in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.