MATTHEW LAURANCE REAGAN


Address: 480 Central Ave, Jbphh, HI 96860-4908
Phone: 8084731880

MATTHEW LAURANCE REAGAN (NPI# 1821502683) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1821502683
Entity Type Individual
Full Name MATTHEW LAURANCE REAGAN
Practice Address 480 Central Ave
Jbphh
HI 96860-4908
Mailing Address 10139 Glennon St
San Diego
CA 92124-2914
Practice Telephone 8084731880
Mailing Telephone 6192740158
Enumeration Date 2017-11-30
Last Update Date 2017-11-30
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1710I1002X Military Health Care Provider
Specialization: Independent Duty Corpsman
Other Service Providers

Office Location

Street Address 480 CENTRAL AVE
City JBPHH
State HI
Zip Code 96860-4908

Providers in the same location

NPI Name Taxonomy Address Enumeration
1255325072 John K Nakagawa Dentist 480 Central Ave, Jbphh, HI 96860-4908 2005-09-07
1639792633 Andrea Kahealani Stanley Registered Nurse 480 Central Ave, Jbphh, HI 96860-4908 2020-05-26
1427689926 Anuree Bennett Registered Nurse 480 Central Ave, Jbphh, HI 96860-4908 2020-02-03
1366073512 George Henry Alba Registered Nurse 480 Central Ave, Jbphh, HI 96860-4908 2020-01-27
1588203400 Christina Marie Narayana Registered Nurse 480 Central Ave, Jbphh, HI 96860-4908 2019-12-23
1528602984 Carrie P Yamamoto Registered Nurse 480 Central Ave, Jbphh, HI 96860-4908 2019-10-29
1356878995 Daryl R Cadelina Registered Nurse 480 Central Ave, Jbphh, HI 96860-4908 2017-05-14
1396282232 Jennifer Sua Registered Nurse 480 Central Ave, Jbphh, HI 96860-4908 2017-01-31
1912368705 Heidi Layton Psychologist 480 Central Ave, Jbphh, HI 96860-4908 2016-03-08
1992162432 Amy Lynn Bene Registered Nurse 480 Central Ave, Jbphh, HI 96860-4908 2016-01-27
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1770075970 April Box Registered Nurse Naval Health Clinic Hawii, 480 Central Avenue, Pearl Harbor, HI 96860 2018-06-04
1760985535 Daniel Thomas Weinberg General Practice 1430 Morton St Bldg 619, Jbphh, HI 96860 2018-03-17
1003325366 Justin Hesse Military Health Care Provider Building 17 Bishop Point, Pearl Harbor, HI 96860 2017-09-29
1982057816 John Alois Kustermann Family Medicine 490 Central Avenue Bldg 281, Honolulu Military Entrance Processing Station, Pearl Harbor, HI 96860 2016-07-15
1104290519 Carlton Jacob Maughan Military Health Care Provider Bldg 17 Bishops Point, Pearl Harbor, HI 96860 2015-11-23
1588079206 Naval Health Clinic Hawaii Military/U.S. Coast Guard Pharmacy Makalapa Rd, Bldg 1407, Pearl Harbor, HI 96860 2014-06-23
1922349968 Jose Israel Lopez Military Health Care Provider Mdsu-1 Bishop Point, Building 17, Pearl Harbor, HI 96860 2013-03-14
1790056620 Lesley Brooke Dorsey Physician Assistant 408 Central Ave, Jbphh, HI 96860 2012-01-24
1184914061 William A Talbott Military Health Care Provider 850 Ticonderoga St, Pearl Harbor, HI 96860 2011-04-13
1275860603 Michael J. Rodriguez Military Health Care Provider 822 Clark St., Nssc Medical Suite 400, Pearl Harbor, HI 96860 2009-11-05
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Taxonomy Information

Taxonomy Code 1710I1002X
Grouping Other Service Providers
Classification Military Health Care Provider
Specialization Independent Duty Corpsman

Taxonomy Definition

A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals.
Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1134759715 David Maldonado Santiago Military Health Care Provider 590 Moffet St, Jbphh, HI 96853-5168 2020-01-22
1437574928 Guy Edward Sargent Military Health Care Provider 480 Central Ave, Jbphh, HI 96860 2014-02-20
1740527589 Cory John Butler Military Health Care Provider 310 Worchester Ave Bldg 45, Jbphh, HI 96853-5530 2013-01-14

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1205441888 William Andrew Fitzpatrick Military Health Care Provider Bldg 6905, Mcbh, HI 96734 2020-09-10
1215549670 Joseph Frabotta Military Health Care Provider 6894r Mokapu Rd, Kailua, HI 96734 2020-08-18
1508484882 David Jason Brown Military Health Care Provider 6255 Kaawa St, Kailua, HI 96734-4984 2020-07-13
1003325366 Justin Hesse Military Health Care Provider Building 17 Bishop Point, Pearl Harbor, HI 96860 2017-09-29
1649796244 Joshua I White Military Health Care Provider Bldg 4078 Harris Rd., Mcbh Kaneohe Bay, HI 96863 2017-08-16
1104290519 Carlton Jacob Maughan Military Health Care Provider Bldg 17 Bishops Point, Pearl Harbor, HI 96860 2015-11-23
1811363120 Timothy Layton Military Health Care Provider 1016 Ulupau Loop, Kailua, HI 96734-4772 2015-08-20
1700263001 Daniel Joseph Engelhardt Military Health Care Provider 5435 Kilmer Ln, Honolulu, HI 96818-3467 2015-05-06
1316350168 Bryan Goodman Military Health Care Provider Bldg #1058, Mcbh Kaneohe Bay, HI 96863 2014-06-10
1902249436 Alex Joseph Valencia Military Health Care Provider 3005 Glen Cove, Kailua, HI 96734-3004 2013-04-15
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Competitor

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City JBPHH
Zip Code 96860

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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