Individual provider Active NPI

Rebecca Rettig, RPH

  • Pharmacist
  • Logansport, IN
National Provider Identifier
1851055875
Registry record updated Oct 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
26017362A Issued in IN
Practice address
3404 E Market St
Logansport, IN 46947-2295
Phone
(574) 753-2312
NPI assigned
Oct 26, 2021
Last updated
Oct 26, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 26017362A IN Primary

Addresses

Primary practice location

3404 E Market St
Logansport, IN 46947-2295

Mailing address

3404 E Market St
Logansport, IN 46947-2295
Phone (574) 360-1060

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)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
26017362AINMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1635206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635206400000",
    "number": "1851055875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3404 E MARKET ST",
            "city": "LOGANSPORT",
            "state": "IN",
            "postal_code": "469472295",
            "telephone_number": "574-360-1060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3404 E MARKET ST",
            "city": "LOGANSPORT",
            "state": "IN",
            "postal_code": "469472295",
            "telephone_number": "574-753-2312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RETTIG",
        "first_name": "REBECCA",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-26",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26017362A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Logansport, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.