Active NPI
Dale L Reinker, D.O.
- Family Medicine Physician
- Troy, MO
National Provider Identifier
1033196894
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- R4225
- Practice address
- 1175 E Cherry St
Troy, MO 63379-1520 - Phone
- (636) 528-7722
- Fax
- (636) 528-7744
- NPI assigned
- Dec 22, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | R4225 | MO | Primary |
Addresses
Primary practice location
1175 E Cherry St
Troy, MO 63379-1520
Mailing address
1175 E Cherry St
P.O. Box 315
Troy, MO 63379-1520
Phone (636) 528-7722
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 242201705 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1275436800000",
"number": "1033196894",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1175 E CHERRY ST",
"address_2": "P.O. BOX 315",
"city": "TROY",
"state": "MO",
"postal_code": "633791520",
"telephone_number": "636-528-7722",
"fax_number": "636-528-7744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1175 E CHERRY ST",
"city": "TROY",
"state": "MO",
"postal_code": "633791520",
"telephone_number": "636-528-7722",
"fax_number": "636-528-7744"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REINKER",
"first_name": "DALE",
"middle_name": "L",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-22",
"last_updated": "2010-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MO",
"license": "R4225",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "242201705",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Troy, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.