1912988684 NPI number — DR. GINA REGHETTI D.O.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912988684 NPI number — DR. GINA REGHETTI D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
REGHETTI
Provider First Name:
GINA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.O.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1912988684
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
THE 110 BUILDING, 110 EDWARD STREET, NW
Provider Second Line Business Mailing Address:
DR. GINA REGHETTI, D.O., PC, INC.
Provider Business Mailing Address City Name:
WARREN
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44483-1118
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-847-3334
Provider Business Mailing Address Fax Number:
330-847-9301

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
THE 110 BUILDING, 110 EDWARD STREET, NW
Provider Second Line Business Practice Location Address:
DR. GINA REGHETTI, D.O., PC, INC.
Provider Business Practice Location Address City Name:
WARREN
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44483-1118
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-847-3334
Provider Business Practice Location Address Fax Number:
330-847-9301
Provider Enumeration Date:
11/09/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 204D00000X , with the licence number:  34-006816-R , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207PE0004X , with the licence number: 34-006816-R , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207PT0002X , with the licence number: 34-006816-R , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207QA0401X , with the licence number: 34-006816-R , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207QA0505X , with the licence number: 34-006816-R , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207QG0300X , with the licence number: 34-006816-R , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207VG0400X , with the licence number: 34-006816-R , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2083P0500X , with the licence number: 34-006816-R , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208VP0014X , with the licence number: 34-006816-R , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 209800000X , with the licence number: 34-006816-R , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000012833-00 . This is a "OHIO BUREAU OF WORKERS' COMPENSATION CERTIFIED" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 1998 . This is a "ADVANCED LIFE SUPPORT IN OBSTETRICS (ALSO) CERTIFICATION" identifier . This identifiers is of the category "OTHER".
  • Identifier: D.O. . This is a "ALUMNI: KIRKSVILLE COLLEGE OF OSTEOPATHIC MEDICINE (KCOM)" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: H051310 . This is a "MEDICARE H051310 TYPE I NATIONAL" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 1983 . This is a "MISS HARLEY-DAVIDSON U.S.A., 1ST. RUNNER UP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1985 . This is a "RECOGNITION OF APPRECIATION FOR HEALTH SERVICES: AMERICAN RED CROSS NE TORNADO" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 1997 . This is a "AMERICAN MEDICAL ASSOCIATION-MEMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1998 . This is a "AMERICAN ACADEMY OF FAMILY PHYSICIANS (AAFP)" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1998 . This is a "FLIGHT FOR LIFE, STAFF FLIGHT SURGEON-EMERGENCY HELICOPTER RESCUES" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2000 . This is a "DISABLED AMERICAN VETERANS, COMMANDER'S CLUB, OUTSTANDING DEVOTION & GENEROSITY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2001 . This is a "AWARD: ONE THOUSAND GREAT AMERICANS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2174418 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1989 . This is a "AWARD: OUTSTANDING COLLEGE STUDENTS OF AMERICA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1997 . This is a "SOCIETY OF TEACHERS OF FAMILY MEDICINE (STFM)" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1998 . This is a "EXPERT WITNESS: FORENSIC ANALYSIS, STATE OF PENNSYLVANIA DEPARTMENT PROSECUTION" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2002 . This is a "AWARD: LIFE MEMEBER, NATIONAL REGISTRY OF WHO'S WHO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2006 . This is a "DAV DISABLED AMERICAN VETERANS' COMMANDER'S CLUB WALL OF HONOR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2007 . This is a "CONSUMERS' RESEARCH COUNSIL OF AMERICA-AMERICA'S TOP FAMILY PHYSICIANS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 29026 . This is a "NATIONAL BOARD OF OSTEOPATHIC MEDICAL EXAMINERS-DIPLOMATE STATUS NATIONALLY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8873 . This is a "AMERICAN OSTEOPATHIC BOARD OF FAMILY PHYSICIANS USA BOARD CERTIFICATIONS" identifier . This identifiers is of the category "OTHER".




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