Active NPI
Stacy Regan, DPT
- Physical Therapist
- Parker, CO
National Provider Identifier
1912155698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PTP-PT-LIC-13117
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | SREGAN837063@WM.PROVIDENCEDIRECT.ORG |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MT
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
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
| License | State | Type | Specialty |
|---|---|---|---|
| PTL.0012996 | CO | MD | Physical Therapist |
| PTP-PT-LIC-13117 | MT | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Barrett Hospital Development Corporation | Current | Accepting new patients | |
| Barrett Hospital Development Corporation | Current | 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
- 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.
-
- Multi-Specialty Clinic/Center
- Twin Bridges, MT
- NPI 1265319255
-
- Medicare Defined Swing Bed Hospital Unit
- Dillon, MT
- NPI 1326419102
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.