Individual provider Active NPI

Amy Denise Reagan, RN

  • Registered Nurse
  • Aiken, SC
National Provider Identifier
1689390304
Registry record updated Oct 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
200653 Issued in SC
Practice address
1135 Gregg Hwy NW
Aiken, SC 29801-6341
Phone
(803) 641-7700
NPI assigned
Oct 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 200653 SC Primary

Addresses

Primary practice location

1135 Gregg Hwy NW
Aiken, SC 29801-6341

Mailing address

1135 Gregg Hwy NW
Aiken, SC 29801-6341
Phone (803) 641-7700

Other practice location 1

431 W Martintown Rd
North Augusta, SC 29841-3187
Phone (803) 278-0880

Other practice location 2

916 Reynolds Rd
Barnwell, SC 29812-6358
Phone (803) 259-7170

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
200653SCMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
South Carolina Dept of Mental Health Accounting Office Past Accepting new patients
South Carolina Dept of Mental Health Accounting Office Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1665705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665705600000",
    "number": "1689390304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 GREGG HWY NW",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298016341",
            "telephone_number": "803-641-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 GREGG HWY NW",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298016341",
            "telephone_number": "803-641-7700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "431 W Martintown Rd",
            "address_purpose": "LOCATION",
            "city": "North Augusta",
            "state": "SC",
            "postal_code": "298413187",
            "country_code": "US",
            "telephone_number": "803-278-0880",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "916 Reynolds Rd",
            "address_purpose": "LOCATION",
            "city": "Barnwell",
            "state": "SC",
            "postal_code": "298126358",
            "country_code": "US",
            "telephone_number": "803-259-7170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REAGAN",
        "first_name": "AMY",
        "middle_name": "DENISE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-14",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "SC",
            "license": "200653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiken, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2022; 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.