Individual provider Active NPI

Smokey Regan, LMT

  • Mechanotherapist
  • Naugatuck, CT
National Provider Identifier
1528349404
Registry record updated Sep 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
MechanotherapistTaxonomy code 172M00000X
License
006703 Issued in CT
Practice address
57 Mistywood LN
Naugatuck, CT 06770-1529
Phone
(203) 729-7161
NPI assigned
Sep 6, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mechanotherapist 172M00000X 006703 CT Primary

Addresses

Primary practice location

57 Mistywood LN
Naugatuck, CT 06770-1529

Mailing address

57 Mistywood LN
Naugatuck, CT 06770-1529
Phone (203) 729-7161

Other identifiers 1

IdentifierTypeStateIssuer
007603OtherCTLISCENSE NUMBER

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
006703CTMDMechanotherapist

NPI Registry JSON

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

{
    "created_epoch": "1315267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315267200000",
    "number": "1528349404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 MISTYWOOD LN",
            "city": "NAUGATUCK",
            "state": "CT",
            "postal_code": "067701529",
            "telephone_number": "203-729-7161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 MISTYWOOD LN",
            "city": "NAUGATUCK",
            "state": "CT",
            "postal_code": "067701529",
            "telephone_number": "203-729-7161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REGAN",
        "first_name": "SMOKEY",
        "name_prefix": "Mrs.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-06",
        "last_updated": "2011-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172M00000X",
            "taxonomy_group": "",
            "desc": "Mechanotherapist",
            "state": "CT",
            "license": "006703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LISCENSE NUMBER",
            "identifier": "007603",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naugatuck, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2011; 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.