Provider Demographics
NPI:1245571694
Name:ABBOTT, REBEKAH JEAN (DO)
Entity type:Individual
Prefix:DR
First Name:REBEKAH
Middle Name:JEAN
Last Name:ABBOTT
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:REBEKAH
Other - Middle Name:JEAN
Other - Last Name:WITTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:4943 STATE HIGHWAY 52 STE 240
Mailing Address - Street 2:
Mailing Address - City:DACONO
Mailing Address - State:CO
Mailing Address - Zip Code:80514-9107
Mailing Address - Country:US
Mailing Address - Phone:303-501-2600
Mailing Address - Fax:877-764-4622
Practice Address - Street 1:10550 QUIVIRA RD STE 405
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66215-2304
Practice Address - Country:US
Practice Address - Phone:303-501-2600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-11
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS05-38799207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSG93000058Medicare PIN