Individual provider Active NPI

Laura T Regan, PT, DPT

  • Physical Therapist
  • Eagle River, AK
National Provider Identifier
1265864565
Registry record updated Aug 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2634 Issued in AK
Practice address
17101 Snowmobile LN Ste 202
Eagle River, AK 99577-7043
Phone
(907) 694-8085
NPI assigned
Aug 8, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2634 AK Primary

Addresses

Primary practice location

17101 Snowmobile LN Ste 202
Eagle River, AK 99577-7043

Mailing address

2612 Eagle St
Wise Physical Therapy & Rehabilitation Inc
Anchorage, AK 99503-2818
Phone (907) 562-2118

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2634AKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Rehab LLC Physical Therapist Current Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1375920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440633600000",
    "number": "1265864565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2612 EAGLE ST",
            "address_2": "WISE PHYSICAL THERAPY & REHABILITATION INC",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995032818",
            "telephone_number": "907-562-2118",
            "fax_number": "907-562-2128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17101 SNOWMOBILE LN STE 202",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777043",
            "telephone_number": "907-694-8085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REGAN",
        "first_name": "LAURA",
        "middle_name": "T",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-08",
        "last_updated": "2015-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "2634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle River, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2015; 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.