Jeffrey M Reagan MD PLLC

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

49407 Issued in AZ

Legal business name

JEFFREY M REAGAN MD PLLC

Practice address

4830 Highway 260 Ste 103
Lakeside, AZ 85929-5851

Phone

(928) 537-8777

Fax

(928) 537-1914

NPI assigned

Jul 16, 2014

Organization subpart

No

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

Authorized official

Name

Jamie Barnett

Title

Office Manager

Phone

(928) 537-8777

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeffrey Maurice Reagan, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Lakeside, AZ
  • NPI 1477750636

  AZ, Sports Medicine

  Medicare reassignment Care Compare group NPD
• Steven K Struthers, PA-C

  • Physician Assistant
  • Lakeside, AZ
  • NPI 1114583291

  AZ

  Medicare reassignment Care Compare group
• Raelynn M. Musick, N.P.

  • Family Nurse Practitioner
  • Show Low, AZ
  • NPI 1073946562

  AZ

  Medicare reassignment NPD

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

{
    "created_epoch": "1405468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405468800000",
    "number": "1194132613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4830 HIGHWAY 260 STE 103",
            "city": "LAKESIDE",
            "state": "AZ",
            "postal_code": "859295851",
            "telephone_number": "928-537-8777",
            "fax_number": "928-537-1914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4830 HIGHWAY 260 STE 103",
            "city": "LAKESIDE",
            "state": "AZ",
            "postal_code": "859295851",
            "telephone_number": "928-537-8777",
            "fax_number": "928-537-1914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY M REAGAN MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-16",
        "last_updated": "2014-07-16",
        "status": "A",
        "authorized_official_last_name": "BARNETT",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "928-537-8777"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "AZ",
            "license": "49407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Lakeside, AZ
• Sports Medicine (Orthopaedic Surgery) Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.