Individual provider Active NPI

Robert A Reese, D.C.

  • Chiropractor
  • Middletown, DE
National Provider Identifier
1114070679
Registry record updated Mar 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3631 Issued in SC
Practice address
401 E. Main Street
BLDG. 4 Suite B
Middletown, DE 19709
Phone
(302) 376-5830
Fax
(302) 376-5832
NPI assigned
Jan 19, 2007
Last updated
Mar 6, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3631 SC Primary
Chiropractor 111N00000X F1-0000491 DE

Addresses

Primary practice location

401 E. Main Street
BLDG. 4 Suite B
Middletown, DE 19709

Mailing address

1037 Anna Knapp Blvd
Ste a
Mt Pleasant, SC 29464-3674
Phone (302) 376-5830

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130924000618 SC Practitioner - Chiropractic 5698763290 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1994
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1037 Anna Knapp Blvd
Suite a
Mt Pleasant, SC 29464-3674

1037 Anna Knapp Blvd a
Mount Pleasant, SC 29464-3674

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F1-0000491DEMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Reese Chiropractic Inc Chiropractor CurrentSince May 3, 2013 Accepting new patients
Carolina Coastal Wellness, LLC Chiropractor CurrentSince Aug 14, 2015 Accepting new patients

Locations

1037 Anna Knapp Blvd
Ste A
Mt Pleasant, SC 29464
Phone (843) 856-9648

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520294400000",
    "number": "1114070679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1037 ANNA KNAPP BLVD",
            "address_2": "STE A",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294643674",
            "telephone_number": "302-376-5830",
            "fax_number": "302-376-5232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E. MAIN STREET",
            "address_2": "BLDG. 4 SUITE B",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "19709",
            "telephone_number": "302-376-5830",
            "fax_number": "302-376-5832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REESE",
        "first_name": "ROBERT",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2018-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "3631",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "DE",
            "license": "F1-0000491",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.