Provider Demographics
NPI:1154388866
Name:SHEELEY, REGAN ROBERT (MD)
Entity type:Individual
Prefix:
First Name:REGAN
Middle Name:ROBERT
Last Name:SHEELEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212A THOMPSON ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28792-2806
Mailing Address - Country:US
Mailing Address - Phone:828-697-3232
Mailing Address - Fax:828-694-7654
Practice Address - Street 1:212A THOMPSON ST
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-2806
Practice Address - Country:US
Practice Address - Phone:828-697-3232
Practice Address - Fax:828-694-7654
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9601723207Q00000X
NC96-01723146D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1154388866Medicaid
F93652Medicare UPIN