Organization Active NPI

Reagan Rehabilitation Outpatient Therapy, LLC

  • Physical Therapist
  • Lebanon, MO
National Provider Identifier
1922421908
Registry record updated Jul 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2001015007 Issued in MO
Legal business name
REAGAN REHABILITATION OUTPATIENT THERAPY, LLC
Practice address
200 W Commercial St
Lebanon, MO 65536-3146
Phone
(417) 718-0712
NPI assigned
Jan 28, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2025

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

Authorized official

Name
Jonathan DW Reagan, MPT
Title
Owner/Staff Therapist
Phone
(855) 786-8782

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 2001015007 MO Primary

Addresses

Primary practice location

200 W Commercial St
Lebanon, MO 65536-3146

Mailing address

PO Box 1736
Lebanon, MO 65536-1736
Phone (417) 718-0712

Other names 1

  • Reagan Rehab Doing business as

National Provider Directory

National Provider Directory

Locations

200 W Commercial St
Lebanon, MO 65536
Phone (417) 718-0712

217 North St
Waynesville, MO 65583
Phone (573) 774-0070

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1390867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751846400000",
    "number": "1922421908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1736",
            "city": "LEBANON",
            "state": "MO",
            "postal_code": "655361736",
            "telephone_number": "417-718-0712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W COMMERCIAL ST",
            "city": "LEBANON",
            "state": "MO",
            "postal_code": "655363146",
            "telephone_number": "417-718-0712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REAGAN REHABILITATION OUTPATIENT THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-28",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-03",
        "status": "A",
        "authorized_official_last_name": "REAGAN",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "DW",
        "authorized_official_title_or_position": "OWNER/STAFF THERAPIST",
        "authorized_official_telephone_number": "855-786-8782",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2001015007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Reagan Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lebanon, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.