Active NPI
Breanna Regan
- Physical Therapist
- Prineville, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 65389
- Practice address
- 1470 NE 3Rd St
Prineville, OR 97754-2906 - Phone
- (541) 447-6846
- Fax
- (541) 447-1243
- NPI assigned
- Aug 8, 2024
- Last updated
- Aug 23, 2024
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 65389 | OR | Primary |
Addresses
Primary practice location
1470 NE 3Rd St
Prineville, OR 97754-2906
Mailing address
1650 Lyndon Farm CT Ste 300
Louisville, KY 40223-5005
Phone (726) 202-3039
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Oregon Health Sciences University School of Medicine, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1470 NE 3Rd St
Prineville, OR 97754-2906
Phone (541) 447-6846
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Proactive LLC | Physical Therapist | Current | Accepting new patients |
| Omnis Omnia Inc. | Past | Accepting new patients |
Locations
1650 Lyndon Farm Ct
Ste 300
Louisville, KY 40223
Phone (726) 202-3039
1470 NE 3rd St
Prineville, OR 97754
Phone (541) 447-6846
450 NW Greenwood Ave
Redmond, OR 97756
Phone (541) 923-0410
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba ProActive Physical Therapy
- Physical Therapy Clinic/Center
- Oregon City, OR
- NPI 1396273199
Physical Therapist
-
dba Peak Performance Physical Therapy
- Orthopedic Physical Therapist
- Redmond, OR
- NPI 1013949239
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1723075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724371200000",
"number": "1528899093",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1650 LYNDON FARM CT STE 300",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402235005",
"telephone_number": "726-202-3039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1470 NE 3RD ST",
"city": "PRINEVILLE",
"state": "OR",
"postal_code": "977542906",
"telephone_number": "541-447-6846",
"fax_number": "541-447-1243"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REGAN",
"first_name": "BREANNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-08",
"last_updated": "2024-08-23",
"certification_date": "2024-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "65389",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Prineville, OR
- Rebound Physical Therapy II, LLC (Rebound Physical Therapy)
- Rebound Physical Therapy Limited Partnership
- Rebound Physical Therapy, LLC
- Brenda Lee Reece
- Monica Dawn Reed
- Hannah Muskrat Reiling, MA LPCI
- Rita L. Rhoden, CHW
- Connor James Richardson, PA
- Rimrock Trails Treatment Services (Rimrock Trails ATS)
- Rise Wellness and Longevity, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.