Active NPI
Mary Ellene Reagan, BSN
- Registered Nurse
- Manchester, NH
National Provider Identifier
1861651671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 047622-21
- Practice address
- 718 Smyth Rd
Manchester, NH 03104-7007 - Phone
- (603) 624-4366
- Fax
- (603) 314-1676
- NPI assigned
- Jun 6, 2008
- Last updated
- Jun 6, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 047622-21 | NH | Primary |
Addresses
Primary practice location
718 Smyth Rd
Manchester, NH 03104-7007
Mailing address
718 Smyth Rd
Manchester, NH 03104-7007
Phone (603) 624-4366
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
- Credentials
- Bachelor on Science - Nursing
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 047622-21 | NH | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212710400000",
"number": "1861651671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "718 SMYTH RD",
"city": "MANCHESTER",
"state": "NH",
"postal_code": "031047007",
"telephone_number": "603-624-4366",
"fax_number": "603-314-1676"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "718 SMYTH RD",
"city": "MANCHESTER",
"state": "NH",
"postal_code": "031047007",
"telephone_number": "603-624-4366",
"fax_number": "603-314-1676"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REAGAN",
"first_name": "MARY",
"middle_name": "ELLENE",
"credential": "BSN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-06",
"last_updated": "2008-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NH",
"license": "047622-21",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manchester, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 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.