Individual provider Active NPI

Regina Buckley Dandy, DO

  • Family Medicine Physician
  • Richmond Hill, GA
National Provider Identifier
1922064336
Registry record updated Sep 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
057286 Issued in GA
Practice address
89 Interchange Dr
Richmond Hill, GA 31324-7661
Phone
(912) 527-5301
Fax
(912) 756-4740
NPI assigned
Apr 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 057286 GA Primary

Addresses

Primary practice location

89 Interchange Dr
Richmond Hill, GA 31324-7661

Mailing address

PO Box 15849
Savannah, GA 31416-2549
Phone (912) 527-5301

Other identifiers 11

IdentifierTypeStateIssuer
046401246DMedicaidGA
404141OtherGAWELLCARE
046401246AMedicaidGA
10069519OtherGAAMERIGROUP
GRP3905OtherGAGA MEDICARE GROUP ID
P00394151OtherGARR MEDICARE
046401246BMedicaidGA
CH5121OtherGARR MEDICARE GROUP ID
G57286MedicaidSC
52206024-001OtherGABCBS GA
046401246CMedicaidGA

Other names 1

  • Regina L. Buckley Former name

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
I20060911000427 GA Practitioner - Family Practice 6507860228 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

101 Yorktown Dr
Fayetteville, GA 30214-1578

101 Yorktown Dr
Suite 100
Fayetteville, GA 30214-7663
Phone (770) 460-4285

1326 Eisenhower Dr
Savannah, GA 31406-3928

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
057286GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group of Georgia LLC Family Medicine CurrentSince May 1, 2019 Accepting new patients
Privia Medical Group of Georgia LLC Family Medicine CurrentSince May 1, 2019 Accepting new patients
Memorial Health Urgentone, Inc. Family Medicine Past Accepting new patients
Memorial Health Urgentone, Inc. Family Medicine Past Accepting new patients

Locations

101 Yorktown Dr
Ste 100
Fayetteville, GA 30214
Phone (770) 460-4285

89 Interchange Dr
Richmond Hill, GA 31324
Phone (912) 527-5301

1326 Eisenhower Dr
#1
Savannah, GA 31406
Phone (912) 691-4100

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • Direct secure messaging: reginadandy@scmgllc.allscriptsdirect.net
  • Direct secure messaging: regina.dandy.1@8042.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472774400000",
    "number": "1922064336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15849",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314162549",
            "telephone_number": "912-527-5301",
            "fax_number": "912-756-4740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 INTERCHANGE DR",
            "city": "RICHMOND HILL",
            "state": "GA",
            "postal_code": "313247661",
            "telephone_number": "912-527-5301",
            "fax_number": "912-756-4740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANDY",
        "first_name": "REGINA",
        "middle_name": "BUCKLEY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-25",
        "last_updated": "2016-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "057286",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046401246D",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "404141",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046401246A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10069519",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA MEDICARE GROUP ID",
            "identifier": "GRP3905",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00394151",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046401246B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP ID",
            "identifier": "CH5121",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G57286",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GA",
            "identifier": "52206024-001",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046401246C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REGINA",
            "last_name": "BUCKLEY",
            "middle_name": "L.",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Richmond Hill, GA

Sources for this page

Verify at the official NPI Registry.