Active NPI
Regina Eason
- Occupational Therapist
- Flagstaff, AZ
National Provider Identifier
1336489640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OTH-005556
- Practice address
- 4446 E Joey Ave
Flagstaff, AZ 86004-2415 - Phone
- (928) 221-9632
- NPI assigned
- Feb 22, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OTH-005556 | AZ | Primary |
Addresses
Primary practice location
4446 E Joey Ave
Flagstaff, AZ 86004-2415
Mailing address
4446 E Joey Ave
Flagstaff, AZ 86004-2415
Phone (928) 221-9632
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
| License | State | Type | Specialty |
|---|---|---|---|
| OTH-005556 | AZ | MD | Occupational Therapist |
| 5556 | AZ | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Lymphedemobile PLLC | Past | 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.
-
- Health Service Clinic/Center
- Flagstaff, AZ
- NPI 1730613886
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1361491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572825600000",
"number": "1336489640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4446 E JOEY AVE",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "860042415",
"telephone_number": "928-221-9632"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4446 E JOEY AVE",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "860042415",
"telephone_number": "928-221-9632"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EASON",
"first_name": "REGINA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-02-22",
"last_updated": "2019-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": "AZ",
"license": "OTH-005556",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Flagstaff, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.