Individual provider Active NPI

Rebecca Lyne Ratliff, NURSE PRACTITIONER

  • Nurse Practitioner
  • Beckley, WV
National Provider Identifier
1851936629
Registry record updated Feb 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
104796 Issued in WV
Practice address
121 George St
Beckley, WV 25801-2607
Phone
(304) 250-0382
Fax
(304) 250-0382
NPI assigned
Nov 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 104796 WV
Nurse Practitioner 363L00000X 104796 WV Primary

Addresses

Primary practice location

121 George St
Beckley, WV 25801-2607

Mailing address

121 George St
Beckley, WV 25801-2607
Phone (304) 250-0382

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

State licenses

LicenseStateTypeSpecialty
104796WVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain State Vascular, Inc. CurrentSince Nov 17, 2019 Accepting new patients
Beckley Vascular Associates PLLC PastSince Nov 17, 2019 Accepting new patients

Locations

121 George St
Beckley, WV 25801
Phone (304) 250-0382

Interoperability endpoints

  • Direct secure messaging: rebecca.ratliff@wvafn.hcadirect.net
  • Direct secure messaging: rebecca.ratliff.1@14333.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1573776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614384000000",
    "number": "1851936629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 GEORGE ST",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258012607",
            "telephone_number": "304-250-0382",
            "fax_number": "304-250-0382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 GEORGE ST",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258012607",
            "telephone_number": "304-250-0382",
            "fax_number": "304-250-0382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATLIFF",
        "first_name": "REBECCA",
        "middle_name": "LYNE",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-15",
        "last_updated": "2021-02-27",
        "certification_date": "2021-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "104796",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WV",
            "license": "104796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beckley, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 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.