Individual provider Active NPI

Regan Wong, PT

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Arlington, TX
National Provider Identifier
1376779520
Registry record updated Feb 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
License
1163013 Issued in TX
Practice address
515 W Mayfield Rd Ste 116
Arlington, TX 76014-2084
Phone
(972) 623-2629
Fax
(972) 623-2661
NPI assigned
Jun 2, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X 1163013 TX Primary

Addresses

Primary practice location

515 W Mayfield Rd Ste 116
Arlington, TX 76014-2084

Mailing address

515 W Mayfield Rd Ste 116
Arlington, TX 76014-2084
Phone (972) 623-2629

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1163013TXMDSports Medicine (Physical Medicine & Rehabilitation) Physician

NPI Registry JSON

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

{
    "created_epoch": "1243900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266278400000",
    "number": "1376779520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 W MAYFIELD RD STE 116",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760142084",
            "telephone_number": "972-623-2629",
            "fax_number": "972-623-2661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 W MAYFIELD RD STE 116",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760142084",
            "telephone_number": "972-623-2629",
            "fax_number": "972-623-2661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "REGAN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-02",
        "last_updated": "2010-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "TX",
            "license": "1163013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2010; 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.