Active NPI
Amanda Michelle Regis, LDO
- Optician
- Kannapolis, NC
National Provider Identifier
1093565954
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 1639
- Practice address
- 338 Oak Avenue Mall Dr
Kannapolis, NC 28081-4340 - Phone
- (980) 384-5412
- NPI assigned
- Mar 25, 2024
- Last updated
- Mar 25, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 1639 | NC | Primary |
Addresses
Primary practice location
338 Oak Avenue Mall Dr
Kannapolis, NC 28081-4340
Mailing address
252 Oak Avenue
120
Kannapolis, NC 28081
Phone (980) 384-5412
Other names 1
- Shelley Regis
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1639 | NC | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1711324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711324800000",
"number": "1093565954",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "252 OAK AVENUE",
"address_2": "120",
"city": "KANNAPOLIS",
"state": "NC",
"postal_code": "28081",
"telephone_number": "980-384-5412"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "338 OAK AVENUE MALL DR",
"city": "KANNAPOLIS",
"state": "NC",
"postal_code": "280814340",
"telephone_number": "980-384-5412"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REGIS",
"first_name": "AMANDA",
"middle_name": "MICHELLE",
"credential": "LDO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-03-25",
"last_updated": "2024-03-25",
"certification_date": "2024-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "NC",
"license": "1639",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SHELLEY",
"last_name": "REGIS",
"credential": "LDO",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Kannapolis, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.