Individual provider Active NPI

Regina Mathews, APN, FNP-BC

  • Family Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1477982270
Registry record updated Dec 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.010827 Issued in IL
Practice address
6307 S Stewart Ave
1St Floor
Chicago, IL 60621-3116
Phone
(773) 896-2565
Fax
(773) 896-2589
NPI assigned
Nov 2, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.010827 IL Primary

Addresses

Primary practice location

6307 S Stewart Ave
1St Floor
Chicago, IL 60621-3116

Mailing address

326 W 64TH St
Chicago, IL 60621-3114
Phone (773) 896-2565

Other identifiers 1

IdentifierTypeStateIssuer
209010827MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20140416001242 IL Practitioner - Nurse Practitioner 9739311242 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Foundation for Outreach ServicesGroup PAC ID 3375507163, 36 clinicians

Practice addresses (Care Compare)

326 W 64TH St
Chicago, IL 60621-3114
Phone (773) 962-3900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.010827ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Access Community Health Network Current Accepting new patients
Foundation for Outreach Services CurrentSince Apr 1, 2015 Accepting new patients
Access Community Health Network CurrentSince Mar 24, 2014 Accepting new patients

Locations

326 W 64th St
#205
Chicago, IL 60621

6307 S Stewart Ave
Fl 1
Chicago, IL 60621
Phone (773) 896-2565

326 W 64th St
Chicago, IL 60621
Phone (773) 962-3900

Organizations & group practices 3

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 1

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": "1383350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482710400000",
    "number": "1477982270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 W 64TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606213114",
            "telephone_number": "773-896-2565",
            "fax_number": "773-896-2589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6307 S STEWART AVE",
            "address_2": "1ST FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606213116",
            "telephone_number": "773-896-2565",
            "fax_number": "773-896-2589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHEWS",
        "first_name": "REGINA",
        "name_prefix": "Ms.",
        "credential": "APN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-02",
        "last_updated": "2016-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.010827",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209010827",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.