Individual provider Active NPI

Elaine Ruth Reinhard, M.D.

  • General Practice Physician
  • Brookhaven, MS
National Provider Identifier
1184787673
Registry record updated Jan 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
17415 Issued in MS
Practice address
519 W Monticello St
Suite B
Brookhaven, MS 39601-3209
Phone
(601) 990-2963
Fax
(601) 833-0530
NPI assigned
Dec 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 17415 MS
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician 2083P0011X 17415 MS
General Practice Physician 208D00000X 17415 MS Primary

Addresses

Primary practice location

519 W Monticello St
Suite B
Brookhaven, MS 39601-3209

Mailing address

519 W Monticello St
Suite B
Brookhaven, MS 39601-3209
Phone (601) 990-2963

Other identifiers 1

IdentifierTypeStateIssuer
05676700MedicaidMS

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)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
17415MSMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Patients Choice Medical Center of Humphreys County, LLC Past Accepting new patients
Montfort Jones Memorial Hospital Past Accepting new patients
Loving Hands Directed Medical Care, PLLC PastSince Jan 16, 2016 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452211200000",
    "number": "1184787673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 W MONTICELLO ST",
            "address_2": "SUITE B",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396013209",
            "telephone_number": "601-990-2963",
            "fax_number": "601-990-2964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 W MONTICELLO ST",
            "address_2": "SUITE B",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396013209",
            "telephone_number": "601-990-2963",
            "fax_number": "601-833-0530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REINHARD",
        "first_name": "ELAINE",
        "middle_name": "RUTH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2016-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "17415",
            "primary": false
        },
        {
            "code": "2083P0011X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "MS",
            "license": "17415",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MS",
            "license": "17415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05676700",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookhaven, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2016; 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.