Naphasorn Reyes

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

Practice address

5720 Scarecrow CT
Fayetteville, NC 28314-8560

Phone

(641) 426-3956

NPI assigned

Jun 12, 2024

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• BLC Group Home LLC

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Fayetteville, NC
  • NPI 1033007646

  Residential Treatment Facility, Emotionally Disturbed Children

  NPD Authorized official

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

{
    "created_epoch": "1718150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1184467714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 CASTLEFIELD LN",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283069677",
            "telephone_number": "641-426-3956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5720 SCARECROW CT",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283148560",
            "telephone_number": "641-426-3956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "NAPHASORN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-12",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Revolution USA Group Incorporated
• Jaime Reyes Gonzalez, MA
• Alexandria Reyes-Smith, RD
• Audrey Rose Pagtalunan Reyes, PT, DPT
• Demira Reyes
• Victoria Ashley Reyna, DO
• Jessica Marie Reynalds, DOT OTR/L
• Alvin E'Shaun Leamond Reynolds, MSW, LCSWA
• Claudia Reynolds
• Elena Terece Reynolds, PA-C

• Emotionally Disturbed Childrens' Residential Treatment Facility in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; 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.