Individual provider Active NPI

Regan G Nodjomian, DPT

  • Physical Therapist
  • Hoover, AL
National Provider Identifier
1104635234
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTH12125 Issued in AL
Practice address
3075 John Hawkins Pkwy Ste N
Hoover, AL 35244-7003
Phone
(205) 202-0874
Fax
(205) 573-3709
NPI assigned
Jan 3, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTH12125 AL Primary

Addresses

Primary practice location

3075 John Hawkins Pkwy Ste N
Hoover, AL 35244-7003

Mailing address

3075 John Hawkins Pkwy Ste N
Hoover, AL 35244-7003
Phone (205) 202-0874

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250421002632 AL Practitioner - Physical Therapist in Private Practice 3971028093 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Magic City Physical TherapyGroup PAC ID 1759792120, 4 clinicians

Practice addresses (Care Compare)

3075 John Hawkins Pkwy
Suite N O
Hoover, AL 35244-1085
Phone (205) 202-0874

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Magic City Physical Therapy Physical Therapist CurrentSince Jan 6, 2025 Accepting new patients

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": "1735862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1104635234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3075 JOHN HAWKINS PKWY STE N",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352447003",
            "telephone_number": "205-202-0874",
            "fax_number": "205-573-3709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3075 JOHN HAWKINS PKWY STE N",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352447003",
            "telephone_number": "205-202-0874",
            "fax_number": "205-573-3709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NODJOMIAN",
        "first_name": "REGAN",
        "middle_name": "G",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-03",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH12125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoover, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.