Individual provider Active NPI

Tammy Marie Reed, DO

  • Emergency Medicine Physician
  • Jacksonville, NC
National Provider Identifier
1124231097
Registry record updated Nov 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2013-02008 Issued in NC
Practice address
317 Western Blvd
Jacksonville, NC 28546-6338
Phone
(910) 712-4210
NPI assigned
May 8, 2007
Last updated
Nov 28, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X TRAINING CERTIFICATE OH
Emergency Medicine Physician 207P00000X 2013-02008 NC Primary

Addresses

Primary practice location

317 Western Blvd
Jacksonville, NC 28546-6338

Mailing address

1935 Oyster Harbour Pkwy SW
Supply, NC 28462-3523
Phone (910) 712-4210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221013002142 FL Practitioner - Emergency Medicine 8820183643

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2013-02008NCMDEmergency Medicine Physician
TRAINING CERTIFICATEOHMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Coverage Services, PC Past Accepting new patients
Emergency Medicine Physicians of Guernsey County, LTD Emergency Medicine Past Accepting new patients

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": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480291200000",
    "number": "1124231097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1935 OYSTER HARBOUR PKWY SW",
            "city": "SUPPLY",
            "state": "NC",
            "postal_code": "284623523",
            "telephone_number": "910-712-4210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 WESTERN BLVD",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466338",
            "telephone_number": "910-712-4210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REED",
        "first_name": "TAMMY",
        "middle_name": "MARIE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-08",
        "last_updated": "2016-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "TRAINING CERTIFICATE",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2013-02008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

Verify at the official NPI Registry.