Active NPI
Regina Brannon, NP
- Nurse Practitioner
- Cranston, RI
National Provider Identifier
1326033457
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- NPP13640
- Practice address
- 75 Sockanosset Cross Rd
Suite 100
Cranston, RI 02920-5558 - Phone
- (401) 946-6200
- Fax
- (401) 275-1992
- NPI assigned
- Sep 14, 2005
- Last updated
- Sep 16, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | NPP13640 | RI | Primary |
Addresses
Primary practice location
75 Sockanosset Cross Rd
Suite 100
Cranston, RI 02920-5558
Mailing address
10 Davol SQ
Suite 400
Providence, RI 02903-4754
Phone (401) 421-4000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 709004045 | Other | RI | GROUP MEDICARE |
| 9002852 | Medicaid | RI |
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
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NPP13640 | RI | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coastal Medical Inc | Nurse Practitioner | Past | Accepting new patients |
| Coastal Medical Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Coastal Medical Lab
- Clinical Medical Laboratory
- Providence, RI
- NPI 1972590552
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379289600000",
"number": "1326033457",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 DAVOL SQ",
"address_2": "SUITE 400",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029034754",
"telephone_number": "401-421-4000",
"fax_number": "401-272-1456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 SOCKANOSSET CROSS RD",
"address_2": "SUITE 100",
"city": "CRANSTON",
"state": "RI",
"postal_code": "029205558",
"telephone_number": "401-946-6200",
"fax_number": "401-275-1992"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRANNON",
"first_name": "REGINA",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-14",
"last_updated": "2013-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "RI",
"license": "NPP13640",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP MEDICARE",
"identifier": "709004045",
"state": "RI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9002852",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cranston, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.