Individual provider Active NPI

Nadine Regis, M.D.

  • Student in an Organized Health Care Education/Training Program
  • Bronx, NY
National Provider Identifier
1912295429
Registry record updated Jun 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1400 Pelham Pkwy S
Building 6// Suite 1B25
Bronx, NY 10461-1138
Phone
(718) 918-5820
NPI assigned
Jul 18, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary
Emergency Medicine Physician 207P00000X 73138 GA

Addresses

Primary practice location

1400 Pelham Pkwy S
Building 6// Suite 1B25
Bronx, NY 10461-1138

Mailing address

1400 Pelham Parkway S.
Building 6// Suite 1B25
Bronx, NY 10461

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150415001884 GA Practitioner - Emergency Medicine 8527386937 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
73138GAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Group of Columbus, LLC Emergency Medicine CurrentSince Dec 30, 2017 Accepting new patients
Phoebe Putney Memorial Hospital Inc Current Accepting new patients
Phoebe Putney Memorial Hospital Inc CurrentSince Jul 1, 2020 Accepting new patients
Heritage Physician Services, LLC Emergency Medicine CurrentSince May 28, 2018 Accepting new patients
Coweta Emergency Group LLC Emergency Medicine CurrentSince Nov 13, 2017 Accepting new patients
Phoebe Cancer Center Surgical Oncology CurrentSince Jul 1, 2020 Accepting new patients
United Emergency Services, Inc. Emergency Medicine CurrentSince Dec 20, 2016 Accepting new patients
Jacobi Medical Center Ed Past Accepting new patients

Locations

500 W 3rd Ave
Ste 101
Albany, GA 31701
Phone (229) 312-5802

417 W 3rd Ave
Albany, GA 31701
Phone (229) 317-2207

100 Frist Ct
Columbus, GA 31909
Phone (706) 494-2100

710 Center St
Columbus, GA 31901
Phone (706) 571-1000

745 Poplar Rd
Newnan, GA 30265
Phone (404) 478-8785

5995 Spring St
Warm Springs, GA 31830
Phone (706) 632-4374

Interoperability endpoints

  • Direct secure messaging: nadine.regis.1@14883.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/8478/brand/1/csg/1/fhir/r4

Organizations & group practices 8

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": "1310947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434326400000",
    "number": "1912295429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 PELHAM PARKWAY S.",
            "address_2": "BUILDING 6// SUITE 1B25",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 PELHAM PKWY S",
            "address_2": "BUILDING 6// SUITE 1B25",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104611138",
            "telephone_number": "718-918-5820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REGIS",
        "first_name": "NADINE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-18",
        "last_updated": "2015-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "73138",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.