Individual provider Active NPI

Reagan McCortney Edwards

  • Student in an Organized Health Care Education/Training Program
  • Tulsa, OK
National Provider Identifier
1609731850
Registry record updated Dec 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1111 W 17TH St
Tulsa, OK 74107-1886
Phone
(918) 561-8324
NPI assigned
Dec 19, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X OK Primary

Addresses

Primary practice location

1111 W 17TH St
Tulsa, OK 74107-1886

Mailing address

1816 E 15TH St
Ada, OK 74820-7103
Phone (580) 272-4388

Other names 1

  • Reagan Lavane McCortney Former name

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

NPI Registry JSON

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

{
    "created_epoch": "1766102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766102400000",
    "number": "1609731850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1816 E 15TH ST",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748207103",
            "telephone_number": "580-272-4388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 W 17TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741071886",
            "telephone_number": "918-561-8324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "REAGAN",
        "middle_name": "MCCORTNEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-12-19",
        "last_updated": "2025-12-19",
        "certification_date": "2025-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REAGAN",
            "last_name": "MCCORTNEY",
            "middle_name": "LAVANE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2025; 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.