Active NPI
Nicole A Regis, O.D.
- Optometrist
- Annapolis, MD
National Provider Identifier
1487090114
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- TA2322
- Practice address
- 127 Lubrano Dr Ste 301
Annapolis, MD 21401-7560 - Phone
- (410) 224-2010
- Fax
- (410) 224-3044
- NPI assigned
- May 21, 2013
- Last updated
- Jul 21, 2022
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | TA2322 | MD | Primary |
Addresses
Primary practice location
127 Lubrano Dr Ste 301
Annapolis, MD 21401-7560
Mailing address
2023 Pulaski Hwy
Havre de Grace, MD 21078-2137
Phone (410) 939-6477
Other practice location 1
2023 Pulaski Hwy
Havre DE Grace, MD 21078-2137
Phone (410) 939-6477
Other names 1
- Nicole A Kershner
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Samuel F. Boles, MD P.C | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Anne Arundel Eye Center
- Ophthalmology Physician
- Annapolis, MD
- NPI 1013763697
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1487090114",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2023 PULASKI HWY",
"city": "HAVRE DE GRACE",
"state": "MD",
"postal_code": "210782137",
"telephone_number": "410-939-6477",
"fax_number": "410-939-6555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "127 LUBRANO DR STE 301",
"city": "ANNAPOLIS",
"state": "MD",
"postal_code": "214017560",
"telephone_number": "410-224-2010",
"fax_number": "410-224-3044"
}
],
"practiceLocations": [
{
"address_1": "2023 Pulaski Hwy",
"address_purpose": "LOCATION",
"city": "Havre DE Grace",
"state": "MD",
"postal_code": "210782137",
"country_code": "US",
"telephone_number": "410-939-6477",
"fax_number": "410-939-6555",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "REGIS",
"first_name": "NICOLE",
"middle_name": "A",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-05-21",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MD",
"license": "TA2322",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "NICOLE",
"last_name": "KERSHNER",
"middle_name": "A",
"credential": "O.D.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Annapolis, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.