Jacob C Reedy, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1010320 Issued in TX

Practice address

1986 W. Hayden Ave
Hayden, ID 83835-7412

Phone

(208) 762-7760

Fax

(208) 762-7740

NPI assigned

Aug 26, 2020

Last updated

Dec 20, 2023By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

85.76 of 100Reported as group

Quality

67.88

Promoting interoperability

87

Improvement activities

40

Cost

78.84

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jacob.reedy.1@16899.direct.athenahealth.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.

• Dirne Health Centers, Inc.

  dba Heritage Health Main

  • Federally Qualified Health Center (FQHC)
  • Coeur d'Alene, ID
  • NPI 1285686477

  Family Medicine

  Medicare reassignment NPD
• Dirne Health Centers, Inc.

  dba Heritage Health CFHL CDA

  • Federally Qualified Health Center (FQHC)
  • Coeur d'Alene, ID
  • NPI 1194397240

  Family Medicine

  NPD
• North Idaho Nephrology Associates, Inc.

  • Medical Specialty Clinic/Center
  • Hayden, ID
  • NPI 1912181090
  NPD (past)
• Carlos a Lozano MD PA

  • Family Medicine Physician
  • San Antonio, TX
  • NPI 1790967362
  NPD (past)
• San Antonio Kidney Disease Center Physicians Group, P.L.L.C.

  • Nephrology Physician
  • Kerrville, TX
  • NPI 1164540134

  Family

  NPD (past)

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

{
    "created_epoch": "1598400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1114530565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1986 W. HAYDEN AVE",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838357412",
            "telephone_number": "208-762-7760",
            "fax_number": "208-762-7740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1986 W. HAYDEN AVE",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838357412",
            "telephone_number": "208-762-7760",
            "fax_number": "208-762-7740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REEDY",
        "first_name": "JACOB",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-26",
        "last_updated": "2023-12-20",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1010320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Ann Purviance, LCPC
• Ram DC Inc (Discover Chiropractic)
• Ramsey Dental Group PLLC
• Lady-Jean M Ramsey, DMD
• Kateri Picard Ray
• Renewed Horizons, LLC
• Renewed Horizons, LLC
• Renewed Horizons, LLC
• Restore Teletherapy, LLC
• Restored Health PLLC (Integrative Wellness Center, LLC)

• Family Nurse Practitioner in Hayden, ID
• Providers in Hayden, ID by specialty
• Family Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.