Individual provider Active NPI

Bianca Lacey Reagan, ARNP

  • Nurse Practitioner
  • Fort Myers, FL
National Provider Identifier
1427815166
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11031394 Issued in FL
Practice address
12105 Lakewood Preserve PL
Fort Myers, FL 33913-9276
Phone
(954) 298-0192
NPI assigned
Feb 29, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11031394 FL Primary

Addresses

Primary practice location

12105 Lakewood Preserve PL
Fort Myers, FL 33913-9276

Mailing address

12105 Lakewood Preserve PL
Fort Myers, FL 33913-9276
Phone (954) 298-0192

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20260113001951 FL Practitioner - Nurse Practitioner 8921584640 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nchmd IncGroup PAC ID 9436139565, 503 clinicians

Practice addresses (Care Compare)

11190 Health Park Blvd
Suite 2102
Naples, FL 34110-5729
Phone (239) 624-1700

Hospital & facility affiliations

  • Naples Community Hospital Hospital, Naples, FL, CCN 100018
  • Lee Memorial Hospital Hospital, Fort Myers, FL, CCN 100012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11031394FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nchmd, Inc CurrentSince Jan 6, 2026 Accepting new patients
Nchmd Inc CurrentSince Jan 6, 2026 Accepting new patients

Locations

11190 Health Park Blvd
Bldg 2
Naples, FL 34110
Phone (239) 624-1700

11190 Health Park Blvd
Naples, FL 34110
Phone (239) 300-9721

680 2nd Ave N
Ste 304
Naples, FL 34102
Phone (239) 261-7711

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 and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1709164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1427815166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12105 LAKEWOOD PRESERVE PL",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339139276",
            "telephone_number": "954-298-0192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12105 LAKEWOOD PRESERVE PL",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339139276",
            "telephone_number": "954-298-0192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REAGAN",
        "first_name": "BIANCA",
        "middle_name": "LACEY",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-29",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11031394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.