Regan Elizabeth Havens, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704346339 Issued in MI

Practice address

3775 Pollina Ave
Fort Gratiot, MI 48059-4140

Phone

(248) 935-4131

NPI assigned

Sep 28, 2022

Sex

Female

Sole proprietor

No

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 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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Henry Ford Health St. John HospitalGroup PAC ID 3173424082, 332 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: regan.havens.p1@direct.phim.nextgenshare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Henry Ford Health St. John Hospital

  • Nurse Practitioner
  • Detroit, MI
  • NPI 1700831500
  Medicare reassignment Care Compare group NPD
• Berkley Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Berkley, MI
  • NPI 1083022735
  Medicare reassignment NPD
• Port Huron Internal Medicine Associates

  • Geriatric Medicine (Internal Medicine) Physician
  • Port Huron, MI
  • NPI 1528252251
  Medicare reassignment NPD
• Henry Ford Health St. John Hospital

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1023088168
  NPD
• Henry Ford Health St. John Hospital

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1912965088
  NPD (past)
• Port Huron Internal Medicine

  • Family Health Clinical Nurse Specialist
  • Port Huron, MI
  • NPI 1437609781
  NPD (past)

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

{
    "created_epoch": "1664323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1164146650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3775 POLLINA AVE",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480594140",
            "telephone_number": "248-935-4131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3775 POLLINA AVE",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480594140",
            "telephone_number": "248-935-4131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVENS",
        "first_name": "REGAN",
        "middle_name": "ELIZABETH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-28",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704346339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hanna Danielle Harlow
• Kristy A Harmon, MSW
• Madison Claire Haron
• Izabella Maria Hart
• Kayla Anne Harvey, MA
• Hawley Institute Physical Therapy & Sports Performance, LLC.
• Shannon Marie Hayden
• Rachel Roxanne Hayman, OTR
• Jordan Head
• Kamoryn Sterling Werner Heilig

• Family Nurse Practitioner in Fort Gratiot, MI
• Providers in Fort Gratiot, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2022; 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.
• 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.