Active NPI
Wayne Allen Reagan, PT
- Physical Therapist
- El Dorado Hills, CA
National Provider Identifier
1790290476
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 293925
- Practice address
- 1996 Ahoy CT
El Dorado Hills, CA 95762-3745 - Phone
- (916) 890-6762
- NPI assigned
- Dec 4, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 293925 | CA | Primary |
Addresses
Primary practice location
1996 Ahoy CT
El Dorado Hills, CA 95762-3745
Mailing address
1996 Ahoy CT
El Dorado Hills, CA 95762-3745
Phone (916) 890-6762
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 293925 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1512345600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698105600000",
"number": "1790290476",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1996 AHOY CT",
"city": "EL DORADO HILLS",
"state": "CA",
"postal_code": "957623745",
"telephone_number": "916-890-6762"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1996 AHOY CT",
"city": "EL DORADO HILLS",
"state": "CA",
"postal_code": "957623745",
"telephone_number": "916-890-6762"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REAGAN",
"first_name": "WAYNE",
"middle_name": "ALLEN",
"name_prefix": "Dr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-12-04",
"last_updated": "2023-10-24",
"certification_date": "2023-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "293925",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Dorado Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.