Individual provider Active NPI

Joanna Regis

  • Family Nurse Practitioner
  • Brockton, MA
National Provider Identifier
1720795495
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2318791 Issued in MA
Practice address
107 Highland St
Brockton, MA 02301-3721
Phone
(774) 386-6700
NPI assigned
Nov 2, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4054891 KY
Family Nurse Practitioner 363LF0000X 2318791 MA Primary

Addresses

Primary practice location

107 Highland St
Brockton, MA 02301-3721

Mailing address

107 Highland St
Brockton, MA 02301-3721
Phone (774) 386-6700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, SC, CT, KY4 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20230117002749 MA Practitioner - Nurse Practitioner 7113398868 Reassigns benefits to 1 organization
I20241030003449 SC Practitioner - Nurse Practitioner 7113398868 Reassigns benefits to 1 organization
I20251103003009 CT Practitioner - Nurse Practitioner 7113398868 Reassigns benefits to 1 organization
I20260504005689 KY Practitioner - Nurse Practitioner 7113398868 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

112 Shores St
Taunton, MA 02780-2938

200 Oceangate
Suite 100
Long Beach, CA 90802-4316

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4054891KYMDFamily Nurse Practitioner
2318791MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Molina Care Connections, LLC. CurrentSince Feb 6, 2023 Accepting new patients

Locations

200 Oceangate
Ste 100
Long Beach, CA 90802
Phone (562) 435-3666

175 Scott Swamp Rd
Farmington, CT 06032
Phone (860) 249-6752

5100 Commerce Crossings Dr
Louisville, KY 40229
Phone (502) 305-6267

1075 Main St
Fl 4
Waltham, MA 02451

4105 Faber Place Dr
Ste 120
North Charleston, SC 29405
Phone (562) 549-3966

Interoperability endpoints

  • Direct secure messaging: jregis14220@direct-prd.molinahealthcare.com

Organizations & group practices 1

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": "1667347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1720795495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 HIGHLAND ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023013721",
            "telephone_number": "774-386-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 HIGHLAND ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023013721",
            "telephone_number": "774-386-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REGIS",
        "first_name": "JOANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-02",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "4054891",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "2318791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.