Individual provider Active NPI

Tiffany Lockhart Reguera, F.N.P.

  • Family Nurse Practitioner
  • Anderson, CA
National Provider Identifier
1962485839
Registry record updated Oct 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
13779 Issued in CA
Practice address
3082 McMurray Dr
Anderson, CA 96007-3544
Phone
(530) 365-4420
Fax
(530) 365-5186
NPI assigned
Nov 23, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 554914 CA
Family Nurse Practitioner 363LF0000X 13779 CA Primary

Addresses

Primary practice location

3082 McMurray Dr
Anderson, CA 96007-3544

Mailing address

2760 N. Balls Ferry Rd.
Anderson, CA 96007-3537
Phone (530) 365-4412

Other names 1

  • Ms. Tiffany Lockhart Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050503000386 CA Practitioner - Nurse Practitioner 0042259681 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
13779CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gateway Medical Services, Inc. CurrentSince Jul 1, 2015 Accepting new patients
John R. Munro M.D. Past Accepting new patients

Locations

3082 McMurray Dr
Anderson, CA 96007
Phone (530) 365-4412

1310 Churn Creek Rd
Ste E5
Redding, CA 96003
Phone (530) 722-9907

Organizations & group practices 2

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": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539907200000",
    "number": "1962485839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2760 N. BALLS FERRY RD.",
            "city": "ANDERSON",
            "state": "CA",
            "postal_code": "960073537",
            "telephone_number": "530-365-4412",
            "fax_number": "530-365-5186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3082 MCMURRAY DR",
            "city": "ANDERSON",
            "state": "CA",
            "postal_code": "960073544",
            "telephone_number": "530-365-4420",
            "fax_number": "530-365-5186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REGUERA",
        "first_name": "TIFFANY",
        "middle_name": "LOCKHART",
        "name_prefix": "Mrs.",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-23",
        "last_updated": "2018-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "554914",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "13779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "LOCKHART",
            "prefix": "MS.",
            "credential": "F.N.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Anderson, CA

Sources for this page

Verify at the official NPI Registry.