REBECCA OLSON BAKKESTUEN


Address: 3200 Blue Ridge Rd Ste 100, Raleigh, NC 27612-8087
Phone: 9197811437

REBECCA OLSON BAKKESTUEN (NPI# 1326382508) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1326382508
Entity Type Individual
Full Name REBECCA OLSON BAKKESTUEN
Credential PAC
Practice Address 3200 Blue Ridge Rd Ste 100
Raleigh
NC 27612-8087
Mailing Address 5220 Greens Dairy Rd
Raleigh
NC 27616-4612
Practice Telephone 9197811437
Mailing Telephone 9192563576
Mailing Fax Number 9197874870
Enumeration Date 2012-11-12
Last Update Date 2020-06-04
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363A00000X Physician Assistant 0010-03833 NC Physician Assistants & Advanced Practice Nursing Providers
N 363AM0700X Physician Assistant
Specialization: Medical
0010-03833 NC Physician Assistants & Advanced Practice Nursing Providers
N 363AM0700X Physician Assistant
Specialization: Medical
PA1925 SC Physician Assistants & Advanced Practice Nursing Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
1701 East Blvd, Charlotte, NC 282035823 7043347800 7044147512
700 E Morehead St Ste 300, Charlotte, NC 282022742 7043347800 7044147512

Office Location

Street Address 3200 BLUE RIDGE RD STE 100
City RALEIGH
State NC
Zip Code 27612-8087

Providers in the same location

NPI Name Taxonomy Address Enumeration
1699769315 Richard B Clinton Radiology 3200 Blue Ridge Rd Ste 100, Raleigh, NC 27612-8087 2005-09-08
1326468893 Nicole A Keefe Radiology 3200 Blue Ridge Rd Ste 100, Raleigh, NC 27612-8087 2014-04-23
1548697238 Koreen D Morgan Physician Assistant 3200 Blue Ridge Rd Ste 100, Raleigh, NC 27612 2013-09-26
1013276021 Teerath Peter Tanpitukpongse Radiology 3200 Blue Ridge Rd Ste 100, Raleigh, NC 27612-8087 2012-05-10
1790076347 Christopher Matthew Long Radiology 3200 Blue Ridge Rd Ste 100, Raleigh, NC 27612-8087 2011-04-29
1124331582 Mustafa Sardar Khan Radiology 3200 Blue Ridge Rd Ste 100, Raleigh, NC 27612-8087 2010-07-14
1427369537 Jamie Doster Mcintyre Internal Medicine 3200 Blue Ridge Rd Ste 100, Raleigh, NC 27612-8087 2010-06-24
1407167687 Ravi R Dalal Radiology 3200 Blue Ridge Rd Ste 100, Raleigh, NC 27612-8087 2010-06-23
1174844427 Shannon L. Tocchio Radiology 3200 Blue Ridge Rd Ste 100, Raleigh, NC 27612-8087 2010-06-21
1336467760 John Phillip Nazarian Radiology 3200 Blue Ridge Rd Ste 100, Raleigh, NC 27612 2010-05-10
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1538714068 George J Henderon Orthotist 5313 Duraleigh Road, Ste 151, Raleigh, NC 27612 2019-08-01
1902399223 Iain Knox Nathaniel Irwin Marriage & Family Therapist 7701 Alborz Dr, Raleigh, NC 27612 2018-06-12
1225525884 Patterns Behavioral Services North Carolina, Inc Assistant Behavior Analyst 3738 National Dr, Ste 110, Raleigh, NC 27612 2018-04-19
1053820720 The Art Counseling L.L.C. Psychologist 4610 Twisted Oaks Drive Apt 1807, Raleigh, NC 27612 2017-09-26
1376052431 Amanda Steed Speech-Language Pathologist 5519 Hamstead Crossing, Raleigh, NC 27612 2017-09-21
1295250991 Neal H. Patel Dds Pllc Dentist 7211 Shellburne Dr, Raleigh, NC 27612 2017-08-03
1811426109 Marquita Randolph-breeden Behavior Technician 5816 Creedmoor Road, Suite 104, Raleigh, NC 27612 2017-06-08
1336518554 Travis Edward Williams Counselor 4801 Glenwood Ave., Suite 200, Raleigh, NC 27612 2015-09-17
1831587476 Harris Teeter LLC Pharmacy 2051 W Millbrook Road, Raleigh, NC 27612 2015-01-06
1780072975 Harris Teeter LLC Pharmacy 2051 W. Millbrook Road, Raleigh, NC 27612 2014-12-23
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Taxonomy Information

Taxonomy Code 363A00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant

Taxonomy Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1457961682 Megan Kathleen Brown Physician Assistant 3024 New Bern Ave Ste 102, Raleigh, NC 27610-1247 2020-08-03
1124640651 Kayla Marie Sincock Physician Assistant 12205 Harcourt Dr, Raleigh, NC 27613-5603 2020-05-06
1093340531 Hannah Stanifer Physician Assistant 510 N Wilmington St Apt 227, Raleigh, NC 27604-8021 2020-03-05
1962035642 Brianna Stolz Physician Assistant 3811 Ed Dr Ste 110, Raleigh, NC 27612-2393 2020-02-20
1316577737 Jacey Elizabeth Byers Physician Assistant 700 Hawes Ct Apt C, Raleigh, NC 27608-1745 2020-01-24
1033756598 Julie A Romeis Physician Assistant 1929 N Hills Dr Unit G, Raleigh, NC 27612-4022 2019-12-04
1346886769 Pooja Parmar Physician Assistant 8804 Bluff Pointe Ct, Raleigh, NC 27615-4172 2019-11-20
1649829557 Bryan Edwards Physician Assistant 4551 New Bern Ave Ste A100, Raleigh, NC 27610-1551 2019-09-04
1790343192 Savanah Palen Mullen Physician Assistant 10208 Cerny St Ste 204, Raleigh, NC 27617-7885 2019-05-31
1356906184 Andrew Paul Apicella Physician Assistant 3024 New Bern Ave Ste 302, Raleigh, NC 27610-1247 2019-05-07
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Competitor

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City RALEIGH
Zip Code 27612

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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