Individual provider Active NPI

Reagan Amber Dobbins

  • Physician Assistant
  • Tahoka, TX
National Provider Identifier
1124501077
Registry record updated Oct 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA16995 Issued in TX
Practice address
2600 Lockwood St
Tahoka, TX 79373-4118
Phone
(806) 998-4604
NPI assigned
Sep 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AT003826 GA
Basic Emergency Medical Technician 146N00000X E030790 GA
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X PA16995 TX Primary

Addresses

Primary practice location

2600 Lockwood St
Tahoka, TX 79373-4118

Mailing address

2600 Lockwood St
Tahoka, TX 79373-4118

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
I20240131005138 TX Practitioner - Physician Assistant 9436502846 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lynn County Hospital DistrictGroup PAC ID 9739149295, 16 clinicians

Practice addresses (Care Compare)

2600 Lockwood St
Tahoka, TX 79373-4118
Phone 8069984533320

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E030790GAMDBasic Emergency Medical Technician
AT003826GAMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Lynn County Hospital District CurrentSince Dec 23, 2023 Accepting new patients
Lynn County Hospital District CurrentSince Dec 23, 2023 Accepting new patients

Locations

1104 N Avenue S
Post, TX 79356
Phone (806) 495-2853

2600 Lockwood St
Tahoka, TX 79373
Phone (806) 998-4533

Organizations & group practices 3

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": "1536192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1124501077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 LOCKWOOD ST",
            "city": "TAHOKA",
            "state": "TX",
            "postal_code": "793734118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 LOCKWOOD ST",
            "city": "TAHOKA",
            "state": "TX",
            "postal_code": "793734118",
            "telephone_number": "806-998-4604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOBBINS",
        "first_name": "REAGAN",
        "middle_name": "AMBER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-06",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": "AT003826",
            "primary": false
        },
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "GA",
            "license": "E030790",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA16995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tahoka, TX

Sources for this page

Verify at the official NPI Registry.