Regina Willard, APN

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

26NJ00139500 Issued in NJ

Practice address

313 South Ave
Fanwood, NJ 07023-1364

Phone

(908) 889-1900

NPI assigned

Dec 1, 2006

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

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  • NPI 1548254725
  NPD (past)
• Medical Imaging of Lehigh Valley PC

  • Diagnostic Radiology Physician
  • Allentown, PA
  • NPI 1134178023
  NPD (past)

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1184792855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 LAWRENCE RD",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078693100",
            "telephone_number": "201-704-3486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 SOUTH AVE",
            "city": "FANWOOD",
            "state": "NJ",
            "postal_code": "070231364",
            "telephone_number": "908-889-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLARD",
        "first_name": "REGINA",
        "name_prefix": "Dr.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NJ",
            "license": "26NJ00139500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Volunteers of America
• Warren E. Kaplan
• Warren E. Kaplan, DPM
• Gabrielle Weisman, LCSW, LCADC
• Westfield Family Chiropractic, LLC
• Cynthia Anne Wilson, OTR/L
• Diana Chen Wong, OTR/L
• Kathleen Wood
• Jianqiang Xiao, DMD
• Muhammad Jahan Zeb

• Acute Care Nurse Practitioner in Fanwood, NJ
• Providers in Fanwood, NJ by specialty
• Acute Care Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.