Active NPI
Ronald Chan Reynon, PT
- Physical Therapist
- Coos Bay, OR
National Provider Identifier
1205096542
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5325
- Practice address
- 2625 Koos Bay Blvd
Coos Bay, OR 97420-4907 - Phone
- (541) 267-2161
- NPI assigned
- Jun 10, 2008
- Last updated
- Jun 10, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5325 | OR | Primary |
Addresses
Primary practice location
2625 Koos Bay Blvd
Coos Bay, OR 97420-4907
Mailing address
284 S 10TH St
Apt 8
Coos Bay, OR 97420-4681
Phone (541) 221-3402
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38167 | CA | MD | General Practice Dentistry |
| 5325 | OR | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213056000000",
"number": "1205096542",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "284 S 10TH ST",
"address_2": "APT 8",
"city": "COOS BAY",
"state": "OR",
"postal_code": "974204681",
"telephone_number": "541-221-3402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2625 KOOS BAY BLVD",
"city": "COOS BAY",
"state": "OR",
"postal_code": "974204907",
"telephone_number": "541-267-2161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNON",
"first_name": "RONALD",
"middle_name": "CHAN",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-06-10",
"last_updated": "2008-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "5325",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coos Bay, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.