Frederick C Reaves, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9103819 Issued in FL

Practice address

2727 Winkler Ave
Fort Myers, FL 33901-9358

Phone

(239) 939-8611

Fax

(904) 346-0113

NPI assigned

Oct 27, 2006

Last updated

Mar 5, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: frederick.reaves.p1@direct.rrhc.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• South Gulf Coast Emergency Physicians PA

  • Emergency Medicine Physician
  • Fort Myers, FL
  • NPI 1124013149
  NPD (past)
• Alpine Emergency Physicians Medical Group, Inc

  • Emergency Medicine Physician
  • El Centro, CA
  • NPI 1205071776
  NPD (past)

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236211200000",
    "number": "1023194750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 634748",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452630042",
            "telephone_number": "239-337-7700",
            "fax_number": "904-346-0113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 WINKLER AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019358",
            "telephone_number": "239-939-8611",
            "fax_number": "904-346-0113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REAVES",
        "first_name": "FREDERICK",
        "middle_name": "C",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2009-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9103819",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA12718",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amberrose A Reale, PSYD
• Karen Reamer, PA
• Alexis Reardon, PA-C
• Cara G Reardon, NP
• David M Reardon, MD
• Rebecca J Bernas, PSYD, PLLC
• Rebeccacamposlcsw, LLC
• Javier Rebolledo, PT
• Erin Elizabeth Reci
• Zoe Reddick, LCSW

• Physician Assistant in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2009; 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.