Charles Regan, PA-C, ATC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601005151 Issued in MI

Practice address

600 Fort St
Suite 100
Port Huron, MI 48060-3941

Phone

(810) 987-9871

Fax

(810) 987-6070

NPI assigned

Apr 18, 2006

Last updated

Feb 29, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI, CA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: charles.regan.1@19270.direct.athenahealth.com

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.

• Henry Ford Health River District Hospital

  dba Henry Ford River District Hospital

  • Family Medicine Physician
  • East China, MI
  • NPI 1265486245
  Medicare reassignment NPD
• Henry Ford Health System

  • Physician Assistant
  • Detroit, MI
  • NPI 1811073901
  Medicare reassignment NPD
• Shriners Hospitals for Children

  • Pediatric Orthopaedic Surgery Physician
  • Sacramento, CA
  • NPI 1679915565
  Medicare reassignment NPD
• Elizabeth Lake Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Waterford, MI
  • NPI 1538585260
  Medicare reassignment
• Harper Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Saint Clair Shores, MI
  • NPI 1992442560
  Medicare reassignment
• Henry Ford Health St. John Hospital

  dba St John North Shores Hospital

  • Podiatrist
  • Harrison Township, MI
  • NPI 1043478910
  Medicare reassignment
• Henry Ford Semi Medical Group

  • Family Medicine Physician
  • Warren, MI
  • NPI 1942317631
  Medicare reassignment
• Lakeside Urgent Care, P. C.

  • Urgent Care Clinic/Center
  • Clinton Township, MI
  • NPI 1720159304
  Medicare reassignment
• Mound Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Warren, MI
  • NPI 1063159630
  Medicare reassignment
• Oxford Urgent Care P L C

  • Specialist
  • Oxford, MI
  • NPI 1700036936
  Medicare reassignment
• Romeo Plank Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Macomb, MI
  • NPI 1184385791
  Medicare reassignment
• Royal Urgent Care, PLLC

  • Internal Medicine Physician
  • Royal Oak, MI
  • NPI 1952833196
  Medicare reassignment

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330473600000",
    "number": "1386609824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 FORT ST",
            "address_2": "SUITE 100",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603941",
            "telephone_number": "810-987-9871",
            "fax_number": "810-987-6070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 FORT ST",
            "address_2": "SUITE 100",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603941",
            "telephone_number": "810-987-9871",
            "fax_number": "810-987-6070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REGAN",
        "first_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "PA-C, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2012-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601005151",
            "primary": true
        },
        {
            "code": "246Z00000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Podduturu Sridhar Reddy, M.D., M.P.H.
• Stacey Ann Redfield, LBSW
• Gregory Ryan Redman
• Timothy G Redman, RPH
• West Reeves, CRNA
• Najibah Khatoon Rehman, MD, MPH
• Nicole Reid, M.A.
• Rebecca Lee Reifert, RDH
• Nick J Reina, MD
• Leonard Reiter II

• Physician Assistant in Port Huron, MI
• Providers in Port Huron, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.