Reggie Green

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

02879 Issued in LA

Legal business name

REGGIE GREEN

Practice address

105 W Cornerview St
Suite B
Gonzales, LA 70737-2839

Phone

(225) 644-6514

Fax

(225) 644-6514

NPI assigned

Oct 11, 2006

Last updated

Apr 29, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Reggie Demone Green

Title

Owner

Phone

(225) 644-6514

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• AYS MEDICAL SUPPLY COMPANY Other name

Locations

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209427200000",
    "number": "1104914373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 WEST CORNERVIEW",
            "address_2": "BLDG B",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707378509",
            "telephone_number": "225-803-3122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 W CORNERVIEW ST",
            "address_2": "SUITE B",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707372839",
            "telephone_number": "225-644-6514",
            "fax_number": "225-644-6514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGGIE GREEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2008-04-29",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "REGGIE",
        "authorized_official_middle_name": "DEMONE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "225-644-6514",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "LA",
            "license": "02879",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1527297",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AYS MEDICAL SUPPLY COMPANY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Rebirth Rehabilitation Counseling LLC
• Kyla Redditt
• Redefine Behavioral Health, LLC
• Redstick Medical Supply
• Reforming Lives Counseling and Consulting, LLC
• Heidi Brignac Remondet
• Renewed Radiance
• Frances E Rensch, DDS
• Revive Again Support Coordination Services LLC
• Revive Again Therapeutic Services

• Durable Medical Equipment & Medical Supplies in Gonzales, LA
• Providers in Gonzales, LA by specialty
• Durable Medical Equipment & Medical Supplies in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; 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.