Individual provider Active NPI

Regina Reevesscaife

  • Other Technician
  • South Bend, IN
National Provider Identifier
1053864058
Registry record updated Jul 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Other TechnicianTaxonomy code 247200000X
Practice address
1611 S Vernon St
South Bend, IN 46613-3214
Phone
(574) 208-7413
NPI assigned
Jul 27, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Other Technician 247200000X Primary

Addresses

Primary practice location

1611 S Vernon St
South Bend, IN 46613-3214

Mailing address

1611 S Vernon St
South Bend, IN 46613-3214
Phone (574) 208-7413

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

NPI Registry JSON

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

{
    "created_epoch": "1469577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469577600000",
    "number": "1053864058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 S VERNON ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466133214",
            "telephone_number": "574-208-7413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 S VERNON ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466133214",
            "telephone_number": "574-208-7413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REEVESSCAIFE",
        "first_name": "REGINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-27",
        "last_updated": "2016-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2016; 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.