Individual provider Active NPI

Stacy Regan, DPT

  • Physical Therapist
  • Parker, CO
National Provider Identifier
1912155698
Registry record updated Apr 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTP-PT-LIC-13117 Issued in MT
Practice address
11960 Lioness Way Ste 280
Parker, CO 80134-5640
Phone
(303) 790-7877
Fax
(303) 799-4676
NPI assigned
Sep 5, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTL.0012996 CO
Physical Therapist 225100000X PTP-PT-LIC-13117 MT Primary

Addresses

Primary practice location

11960 Lioness Way Ste 280
Parker, CO 80134-5640

Mailing address

600 Mt Highway 91 S
Dillon, MT 59725-7379
Phone (406) 683-3000

Other practice location 1

600 Mt Highway 91 S
Dillon, MT 59725-7379
Phone (406) 683-3000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address SREGAN837063@WM.PROVIDENCEDIRECT.ORG

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180109001276 MT Practitioner - Physical Therapist in Private Practice 7618284845 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Barrett Hospital Development CorporationGroup PAC ID 4082904487, 30 clinicians

Practice addresses (Care Compare)

600 Mt Hwy 91 S
Dillon, MT 59725-7379
Phone (406) 683-3000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTL.0012996COMDPhysical Therapist
PTP-PT-LIC-13117MTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Barrett Hospital Development Corporation CurrentSince Oct 23, 2017 Accepting new patients
Barrett Hospital Development Corporation CurrentSince Oct 23, 2017 Accepting new patients
Barrett Hospital Development Corporation Past Accepting new patients

Locations

600 MT Highway 91 S
Dillon, MT 59725
Phone (406) 683-3001

30 MT Highway 91 S
Dillon, MT 59725
Phone (406) 414-5070

Interoperability endpoints

  • Direct secure messaging: sregan837063@wm.providencedirect.org

Organizations & group practices 3

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": "1220572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619740800000",
    "number": "1912155698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 MT HIGHWAY 91 S",
            "city": "DILLON",
            "state": "MT",
            "postal_code": "597257379",
            "telephone_number": "406-683-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11960 LIONESS WAY STE 280",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801345640",
            "telephone_number": "303-790-7877",
            "fax_number": "303-799-4676"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Mt Highway 91 S",
            "address_purpose": "LOCATION",
            "city": "Dillon",
            "state": "MT",
            "postal_code": "597257379",
            "country_code": "US",
            "telephone_number": "406-683-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REGAN",
        "first_name": "STACY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-05",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0012996",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MT",
            "license": "PTP-PT-LIC-13117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "SREGAN837063@WM.PROVIDENCEDIRECT.ORG",
            "affiliation": "N",
            "address_1": "600 Mt Highway 91 S",
            "city": "Dillon",
            "state": "MT",
            "country_code": "US",
            "postal_code": "597257379",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Parker, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.