Kevin P Reagan, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

16148 Issued in NE

Practice address

11704 W Center Rd
Suite 210
Omaha, NE 68144-4375

Phone

(402) 330-2727

NPI assigned

Aug 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Alegent Creighton Clinic

  • Family Medicine Physician
  • Omaha, NE
  • NPI 1548287907
  NPD (past)
• Alegent Creighton Clinic

  • Family Medicine Physician
  • Council Bluffs, IA
  • NPI 1598811069

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218067200000",
    "number": "1831206978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11704 W CENTER RD",
            "address_2": "SUITE 210",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681444375",
            "telephone_number": "402-330-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11704 W CENTER RD",
            "address_2": "SUITE 210",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681444375",
            "telephone_number": "402-330-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REAGAN",
        "first_name": "KEVIN",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2008-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NE",
            "license": "16148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47083900200",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAVELERS RR MEDICARE",
            "identifier": "110219831",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• RCR Counseling LLC
• Re-New Institute LLC
• Chad Allan Reade, M.D.
• Sydney Readman
• Jada Ready
• Mary Catherine Reagan
• Real Talk Therapy Services, LLC
• Holly Real
• Ethel Reales
• Portia Reams

• All providers in Omaha, NE
• Internal Medicine Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.