Individual provider Active NPI

Rebecca L Warnken

  • Dentist
  • Bradenton, FL
National Provider Identifier
1831538669
Registry record updated Jun 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN20139 Issued in FL
Practice address
2107 59TH St W
Bradenton, FL 34209-7015
Phone
(941) 792-4153
Fax
(941) 794-6359
NPI assigned
Jun 14, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN20139 FL Primary

Addresses

Primary practice location

2107 59TH St W
Bradenton, FL 34209-7015

Mailing address

2107 59TH St W
Bradenton, FL 34209-7015
Phone (941) 792-4153

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150609001077 FL Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 7113248659

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN20139FLMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1371168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371168000000",
    "number": "1831538669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2107 59TH ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342097015",
            "telephone_number": "941-792-4153",
            "fax_number": "941-794-6359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2107 59TH ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342097015",
            "telephone_number": "941-792-4153",
            "fax_number": "941-794-6359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARNKEN",
        "first_name": "REBECCA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-14",
        "last_updated": "2013-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN20139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.