Individual provider Active NPI

Brittany J Regalado, FNP-C

  • Family Medicine Physician
  • Wyandotte, MI
National Provider Identifier
1104557537
Registry record updated Jun 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4704304686 Issued in MI
Practice address
2201 Ford Ave
Wyandotte, MI 48192-2314
Phone
(734) 258-8835
NPI assigned
Jun 17, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4704304686 MI Primary

Addresses

Primary practice location

2201 Ford Ave
Wyandotte, MI 48192-2314

Mailing address

2201 Ford Ave
Wyandotte, MI 48192-2314
Phone (734) 258-8835

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250129000378 MI Practitioner - Nurse Practitioner 4486183969 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Billy R Nordyke Jr DO PC Family Medicine CurrentSince Nov 17, 2024 Accepting new patients

Locations

2201 Ford Ave
Wyandotte, MI 48192
Phone (734) 258-8835

Interoperability endpoints

  • Direct secure messaging: brittany.regalado.3@18306.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1655424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655424000000",
    "number": "1104557537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 FORD AVE",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481922314",
            "telephone_number": "734-258-8835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 FORD AVE",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481922314",
            "telephone_number": "734-258-8835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REGALADO",
        "first_name": "BRITTANY",
        "middle_name": "J",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-17",
        "last_updated": "2022-06-17",
        "certification_date": "2022-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4704304686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyandotte, MI

Sources for this page

Verify at the official NPI Registry.