Sandra Harrison Rakestraw, RN, CDE

Primary specialty

Diabetes Educator Registered NurseTaxonomy code 163WD0400X

License

43121 Issued in VA

Practice address

103 W Stadium Dr
Eden, NC 27288-3329

Phone

(336) 627-4854

Fax

(336) 627-8925

NPI assigned

Jun 13, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1528848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528848000000",
    "number": "1992298012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 GRANT ST",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272885216",
            "telephone_number": "336-613-0217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 W STADIUM DR",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272883329",
            "telephone_number": "336-627-4854",
            "fax_number": "336-627-8925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAKESTRAW",
        "first_name": "SANDRA",
        "middle_name": "HARRISON",
        "name_prefix": "Ms.",
        "credential": "RN, CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-13",
        "last_updated": "2018-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "VA",
            "license": "43121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Diabetes Educator Registered Nurse in Eden, NC
• Providers in Eden, NC by specialty
• Diabetes Educator Registered Nurse in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2018; 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.