Individual provider Active NPI

Bridget Grace Regan, PT

  • Physical Therapist
  • Kissimmee, FL
National Provider Identifier
1902226517
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40839 Issued in FL
Practice address
2781 Eagle Vista CT
Kissimmee, FL 34746-3175
Phone
(832) 386-5558
NPI assigned
Apr 22, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40839 FL Primary

Addresses

Primary practice location

2781 Eagle Vista CT
Kissimmee, FL 34746-3175

Mailing address

2781 Eagle Vista CT
Kissimmee, FL 34746-3175
Phone (832) 386-5558

Other names 1

  • Bridget Kolek Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240329001982 FL Practitioner - Physical Therapist in Private Practice 6103155700 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40839FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dedicated Physical Therapy and Wellness LLC Physical Therapist CurrentSince Mar 1, 2024 Accepting new patients
Stern at Home Physical Therapy PC Physical Therapist PastSince Mar 1, 2024 Accepting new patients

Organizations & group practices 2

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": "1398124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1902226517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2781 EAGLE VISTA CT",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347463175",
            "telephone_number": "832-386-5558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2781 EAGLE VISTA CT",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347463175",
            "telephone_number": "832-386-5558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REGAN",
        "first_name": "BRIDGET",
        "middle_name": "GRACE",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-22",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "40839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRIDGET",
            "last_name": "KOLEK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.