NPIMap

Organization Active NPI

Daniel J Reichenbach MD PC

  • Surgery Physician
  • Brunswick, GA
National Provider Identifier
1134326226
Registry record updated Nov 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
056472 Issued in GA
Legal business name
DANIEL J REICHENBACH MD PC
Practice address
3020 Shrine Rd
Brunswick, GA 31520-4743
Phone
(912) 267-0533
Fax
(912) 267-7313
NPI assigned
Jul 2, 2007
Last updated
Nov 2, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2007

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

Authorized official

Name
Daniel J Reichenbach, M.D.NPI 1396765715
Title
President
Phone
(912) 265-0492

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 056472 GA Primary

Addresses

Primary practice location

3020 Shrine Rd
Brunswick, GA 31520-4743

Mailing address

3226 Hampton Ave
Ste B
Brunswick, GA 31520-4225
Phone (912) 265-0492

Other identifiers 3

IdentifierTypeStateIssuer
11625808OtherGACAQH
344048OtherGAWELLCARE
10062814OtherGAAMERIGROUP

National Provider Directory

National Provider Directory

Locations

3226 Hampton Ave
Ste B
Brunswick, GA 31520
Phone (912) 265-0492

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193961600000",
    "number": "1134326226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3226 HAMPTON AVE",
            "address_2": "STE B",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204225",
            "telephone_number": "912-265-0492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 SHRINE RD",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204743",
            "telephone_number": "912-267-0533",
            "fax_number": "912-267-7313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANIEL J REICHENBACH MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-02",
        "last_updated": "2007-11-02",
        "status": "A",
        "authorized_official_last_name": "REICHENBACH",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "912-265-0492",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "056472",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11625808",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "344048",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10062814",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2007; 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.