Marilyn L Regis, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME 24512 Issued in FL

Practice address

1845 Holsonback Dr
Daytona Beach, FL 32117-5114

Phone

(386) 274-0790

Fax

(386) 274-0800

NPI assigned

Mar 21, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Florida Dept. of Health

  • Public Health or Welfare Agency
  • Orange City, FL
  • NPI 1508983669
  NPD (past)

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354752000000",
    "number": "1073572863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9190",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321209190",
            "telephone_number": "386-274-0790",
            "fax_number": "386-274-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1845 HOLSONBACK DR",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175114",
            "telephone_number": "386-274-0790",
            "fax_number": "386-274-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REGIS",
        "first_name": "MARILYN",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-21",
        "last_updated": "2012-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME 24512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "267343600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jesse Akers Reagin, DMD
• Recovering Futures Inc.
• Robert Nolan Reed, LMHC
• Ryan R Rees, M.D.
• William Andrew Reese, MD
• Gail Eve Reich, M.S.
• Erin Lynn Reid
• Timothy Lee Reid, M.D.
• Deborah Marie Reilly
• John Francis Reilly Jr., M.D.

• Pediatrics Physician in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2012; 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.