Stephany Larsen Reagan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA15017 Issued in TX

Practice address

713 E Anderson St
Weatherford, TX 76086-5705

Phone

(682) 582-1000

NPI assigned

Aug 6, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Questcare Medical Services, PLLC

  • Emergency Medicine Physician
  • Dallas, TX
  • NPI 1912059247

  Physician Assistant

  Medicare reassignment NPD
• Questcare Medical Services, PLLC

  • Nurse Practitioner
  • Arlington, TX
  • NPI 1497807713

  Physician Assistant

  NPD

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

{
    "created_epoch": "1596672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637193600000",
    "number": "1134739808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13721 PARKLINE WAY",
            "city": "ALEDO",
            "state": "TX",
            "postal_code": "760081615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 E ANDERSON ST",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760865705",
            "telephone_number": "682-582-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REAGAN",
        "first_name": "STEPHANY",
        "middle_name": "LARSEN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-06",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA15017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Rankin
• Rylan Weston Ranta
• Melissa A Raschbaum, CRNA
• Ravi Pachigolla MD PSC
• Anna Ray
• Gayatri Reddy, M. D.
• Guduru Ramana Reddy, MD
• Rediclinic US, LLC
• Kelsey Reed
• Rehab Concepts

• Physician Assistant in Weatherford, TX
• Providers in Weatherford, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.