Individual provider Active NPI

Renee N Regis, OTR/L

  • Pediatric Occupational Therapist
  • Newark, NY
National Provider Identifier
1699197988
Registry record updated May 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
009453-1 Issued in NY
Practice address
848 Peirson Ave
Newark, NY 14513-9762
Phone
(315) 331-2086
NPI assigned
Jan 6, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 009453-1 NY Primary

Addresses

Primary practice location

848 Peirson Ave
Newark, NY 14513-9762

Mailing address

848 Peirson Ave
Newark, NY 14513-9762
Phone (315) 331-2086

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
009453-1NYMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1388966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432857600000",
    "number": "1699197988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "848 PEIRSON AVE",
            "city": "NEWARK",
            "state": "NY",
            "postal_code": "145139762",
            "telephone_number": "315-331-2086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "848 PEIRSON AVE",
            "city": "NEWARK",
            "state": "NY",
            "postal_code": "145139762",
            "telephone_number": "315-331-2086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REGIS",
        "first_name": "RENEE",
        "middle_name": "N",
        "name_prefix": "Ms.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-06",
        "last_updated": "2015-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NY",
            "license": "009453-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2015; 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.