Jeffery David Regal, AU.D.,CCC-A

Primary specialty

AudiologistTaxonomy code 231H00000X

License

23002023A Issued in IN

Practice address

100 Navarre Place
Suite 4430
South Bend, IN 46601-1171

Phone

(574) 246-1000

Fax

(574) 246-4000

NPI assigned

Nov 17, 2006

Sex

Male

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 IN

Enrollment records 1

Specialty

Qualified Audiologist

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The South Bend Clinic LLCGroup PAC ID 3779577937, 171 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/3596/brand/1/csg/1/fhir/r4
• FHIR API: https://epicproxy.et1296.epichosted.com/APIProxyPRD/api/FHIR/R4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The South Bend Clinic LLC

  • Clinic/Center
  • South Bend, IN
  • NPI 1073680419
  Medicare reassignment Care Compare group NPD
• Lunsford Audiology, LLC

  dba Audiology Associates of Indiana

  • Assistive Technology Practitioner Audiologist
  • Rushville, IN
  • NPI 1093466088
  Medicare reassignment NPD
• Ear, Nose and Throat of Michiana P.C.

  dba Campbell Ear, Nose and Throat

  • Specialist
  • Granger, IN
  • NPI 1295726198
  NPD
• The South Bend Clinic, LLC

  • Anesthesiology Physician
  • South Bend, IN
  • NPI 1487307492
  NPD

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198108800000",
    "number": "1235203878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 JEFFREY LN",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491207706",
            "telephone_number": "269-684-2324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NAVARRE PLACE",
            "address_2": "SUITE 4430",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011171",
            "telephone_number": "574-246-1000",
            "fax_number": "574-246-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REGAL",
        "first_name": "JEFFERY",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "AU.D.,CCC-A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2007-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IN",
            "license": "23002023A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthiia Ann Reese, N.P.
• Ruth Reese, RN
• Regina Reevesscaife
• Reflections Counseling
• Darah Jean Regal, AU.D.
• Gemma Regan, LPN, LCCE, IBCLC
• Jamie P Reinebold, LCSW
• Jan Reineke, M.D.
• McKinzie Reith, BCBA, LBA
• Kiersten Remenih, BSW

• Audiologist in South Bend, IN
• Providers in South Bend, IN by specialty
• Audiologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.