Individual provider Active NPI

Karen Regan, PTA

  • Physical Therapy Assistant
  • Wading River, NY
National Provider Identifier
1487751806
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
002983-1 Issued in NY
Practice address
6244 Route 25a - BLDG C
Wading River, NY 11792
Phone
(631) 929-3277
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 002983-1 NY Primary

Addresses

Primary practice location

6244 Route 25a - BLDG C
Wading River, NY 11792

Mailing address

10 Peekskill Ave
Patchogue, NY 11772-1429
Phone (631) 654-5516

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
002983-1NYMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487751806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 PEEKSKILL AVE",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117721429",
            "telephone_number": "631-654-5516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6244 ROUTE 25A - BLDG C",
            "city": "WADING RIVER",
            "state": "NY",
            "postal_code": "11792",
            "telephone_number": "631-929-3277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REGAN",
        "first_name": "KAREN",
        "name_prefix": "Ms.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "002983-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wading River, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.