Individual provider Active NPI

Thomas Gaby Reagin, O.D.

  • Optometrist
  • Decatur, GA
National Provider Identifier
1801832258
Registry record updated Jan 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT000891 Issued in GA
Practice address
104 Church St
Decatur, GA 30030-3325
Phone
(404) 378-3694
Fax
(404) 373-0741
NPI assigned
Jun 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT000891 GA Primary

Addresses

Primary practice location

104 Church St
Decatur, GA 30030-3325

Mailing address

104 Church St
Decatur, GA 30030-3325
Phone (404) 378-3694

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

LicenseStateTypeSpecialty
OPT000891GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Reagin Decatur Group, LLC PastSince Aug 5, 2018 Accepting new patients

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": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200614400000",
    "number": "1801832258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 CHURCH ST",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300303325",
            "telephone_number": "404-378-3694",
            "fax_number": "404-373-0741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 CHURCH ST",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300303325",
            "telephone_number": "404-378-3694",
            "fax_number": "404-373-0741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REAGIN",
        "first_name": "THOMAS",
        "middle_name": "GABY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2008-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT000891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2008; 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.