Individual provider Active NPI

James Brody Reid, M.D.

  • Emergency Medicine Physician
  • Alton, IL
National Provider Identifier
1184005910
Registry record updated Dec 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036.147149 Issued in IL
Practice address
1 Memorial Dr
Alton, IL 62002-6722
Phone
(618) 463-7311
NPI assigned
Jun 17, 2015
Last updated
Dec 28, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Emergency Medicine Physician 207P00000X 036.147149 IL Primary

Addresses

Primary practice location

1 Memorial Dr
Alton, IL 62002-6722

Mailing address

2209 W 4TH Ave
Spokane, WA 99201-5402
Phone (678) 603-3503

Other practice location 1

1522 E A St
Casper, WY 82601-2217
Phone (307) 234-6161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, IL, GA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20180521000781 WA Practitioner - Emergency Medicine 5193034627 Reassigns benefits to 1 organization
I20181112002122 IL Practitioner - Emergency Medicine 5193034627 Reassigns benefits to 1 organization
I20200928001099 GA Practitioner - Family Practice 5193034627 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acs Primary Care Physicians - Southeast PCGroup PAC ID 5193620714, 409 clinicians

Practice addresses (Care Compare)

163 Hospital Dr
Toccoa, GA 30577-6820
Phone (706) 886-6841

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.147149ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Emergency Physicians LLC Emergency Medicine CurrentSince May 1, 2018 Accepting new patients
Southeastern Emergency Physicians of Memphis LLC Emergency Medicine CurrentSince Sep 22, 2018 Accepting new patients
Sound Physicians Emergency Medicine of Georgia PC Emergency Medicine CurrentSince Dec 1, 2021 Accepting new patients
Acs Primary Care Physicians - Southeast PC Emergency Medicine CurrentSince Sep 1, 2020 Accepting new patients

Locations

367 Clear Creek Pkwy
Lavonia, GA 30553
Phone (706) 356-1072

2151 W Spring St
Monroe, GA 30655
Phone (770) 267-1792

163 Hospital Dr
Toccoa, GA 30577
Phone (706) 282-4200

1 Memorial Dr
Alton, IL 62002
Phone (618) 463-7240

915 Anderson Dr
Aberdeen, WA 98520
Phone (360) 532-8330

1717 S J St
Tacoma, WA 98405
Phone (253) 426-4101

Interoperability endpoints

  • Direct secure messaging: jreid675921@direct.carenet.org

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1434499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545955200000",
    "number": "1184005910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2209 W 4TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992015402",
            "telephone_number": "678-603-3503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEMORIAL DR",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026722",
            "telephone_number": "618-463-7311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1522 E A St",
            "address_purpose": "LOCATION",
            "city": "Casper",
            "state": "WY",
            "postal_code": "826012217",
            "country_code": "US",
            "telephone_number": "307-234-6161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REID",
        "first_name": "JAMES",
        "middle_name": "BRODY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-17",
        "last_updated": "2018-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036.147149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alton, IL

Sources for this page

Verify at the official NPI Registry.