Individual provider Active NPI

Brandon Ryle Regan

  • Occupational Therapy Assistant
  • West Monroe, LA
National Provider Identifier
1679861082
Registry record updated Jul 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
Z20286 Issued in LA
Practice address
200 Fairfield St
West Monroe, LA 71291-4612
Phone
(318) 324-1611
NPI assigned
Jul 19, 2011
Last updated
Jul 19, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 207608 TX
Occupational Therapy Assistant 224Z00000X Z20286 LA Primary

Addresses

Primary practice location

200 Fairfield St
West Monroe, LA 71291-4612

Mailing address

200 Fairfield St
West Monroe, LA 71291-4612

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
Z20286LAMDOccupational Therapy Assistant
207608TXMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1311033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311033600000",
    "number": "1679861082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 FAIRFIELD ST",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712914612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 FAIRFIELD ST",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712914612",
            "telephone_number": "318-324-1611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REGAN",
        "first_name": "BRANDON",
        "middle_name": "RYLE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-19",
        "last_updated": "2011-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "207608",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "LA",
            "license": "Z20286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Monroe, LA

Sources for this page

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