Anissa Lynn Reagor, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

19573 Issued in TX

Practice address

1210 Douglass Rd
Nacogdoches, TX 75964-4904

Phone

(936) 560-1122

Fax

(936) 560-1631

NPI assigned

Aug 23, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Anissa Lynn Sommers Former name

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• East Texas Community Health Services, Inc

  • Community/Retail Pharmacy
  • Nacogdoches, TX
  • NPI 1457216665
  NPD (past)
• East Texas Community Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Nacogdoches, TX
  • NPI 1255367090
  NPD (past)

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1073629788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 632040",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759632040",
            "telephone_number": "936-560-1122",
            "fax_number": "936-560-1631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 DOUGLASS RD",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759644904",
            "telephone_number": "936-560-1122",
            "fax_number": "936-560-1631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REAGOR",
        "first_name": "ANISSA",
        "middle_name": "LYNN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-23",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "19573",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "19573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANISSA",
            "last_name": "SOMMERS",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• James Michael Randle, M.D.
• Ranek, LC
• Sandra Patricia Rangel
• Deborah Elaine Rankin, RPH
• Joseph Gerard Rauma, P.T.A.
• Louis E Rector, DDS
• James Earl Redfield Jr., MD
• Charlene Reed, LCSW
• Kristin Reese
• Sydney Kroll Register, PSY.D.

• Dentist in Nacogdoches, TX
• Providers in Nacogdoches, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.