Individual provider Active NPI

Evan C Reese Jr., M.D.

  • Orthopaedic Surgery Physician
  • Beaufort, SC
National Provider Identifier
1154365575
Registry record updated Jun 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
31372 Issued in SC
Practice address
1251 B Ribaut Rd
Beaufort, SC 29902
Phone
(843) 524-3015
Fax
(813) 524-3020
NPI assigned
Jun 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD030154L PA
Orthopaedic Surgery Physician 207X00000X 31372 SC Primary

Addresses

Primary practice location

1251 B Ribaut Rd
Beaufort, SC 29902

Mailing address

1251 B Ribaut Rd
Beaufort, SC 29902
Phone (843) 524-3015

Other identifiers 2

IdentifierTypeStateIssuer
00641759-0001MedicaidPA
641759MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD030154LPAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497744000000",
    "number": "1154365575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1251 B RIBAUT RD",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "29902",
            "telephone_number": "843-524-3015",
            "fax_number": "813-524-3020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 B RIBAUT RD",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "29902",
            "telephone_number": "843-524-3015",
            "fax_number": "813-524-3020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REESE",
        "first_name": "EVAN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2017-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PA",
            "license": "MD030154L",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "SC",
            "license": "31372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00641759-0001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "641759",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaufort, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2017; 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.