Individual provider Active NPI

Regan L Anthony, PA-C

  • Physician Assistant
  • Lubbock, TX
National Provider Identifier
1114538501
Registry record updated Jan 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA15030 Issued in TX
Practice address
602 Indiana Ave
Lubbock, TX 79415-3364
Phone
(806) 775-8200
NPI assigned
Aug 11, 2020
Last updated
Jan 13, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA15030 TX Primary

Addresses

Primary practice location

602 Indiana Ave
Lubbock, TX 79415-3364

Mailing address

5220 Kemper St
Lubbock, TX 79416-7412
Phone (806) 265-5001

Other practice location 1

3600 N Garfield St
Midland, TX 79705-6329
Phone (806) 743-3220

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211214002747 TX Practitioner - Physician Assistant 2567852148 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lubbock County Hospital DistrictGroup PAC ID 4284617507, 65 clinicians

Practice addresses (Care Compare)

11011 Slide Rd
Lubbock, TX 79424-2274
Phone (806) 775-8459

602 Indiana Ave
Lubbock, TX 79415-3364
Phone (806) 775-9700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA15030TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lubbock County Hospital District Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1597104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642032000000",
    "number": "1114538501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5220 KEMPER ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794167412",
            "telephone_number": "806-265-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 INDIANA AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794153364",
            "telephone_number": "806-775-8200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3600 N Garfield St",
            "address_purpose": "LOCATION",
            "city": "Midland",
            "state": "TX",
            "postal_code": "797056329",
            "country_code": "US",
            "telephone_number": "806-743-3220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANTHONY",
        "first_name": "REGAN",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-11",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA15030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.