Individual provider Active NPI

Eric David Reitz, M.D.

  • Surgery Physician
  • Clyde, NC
National Provider Identifier
1245220573
Registry record updated Nov 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
94-00992 Issued in NC
Practice address
40 Brettwood Trce
Clyde, NC 28721-8021
Phone
(828) 456-8633
Fax
(828) 452-2792
NPI assigned
Oct 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 94-00992 NC Primary

Addresses

Primary practice location

40 Brettwood Trce
Clyde, NC 28721-8021

Mailing address

40 Brettwood Trce
Clyde, NC 28721-8021
Phone (828) 456-8633

Other identifiers 1

IdentifierTypeStateIssuer
8971211MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080131000562 NC Practitioner - General Surgery 5890898522 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
94-00992NCMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Western Carolina Physician Practices LLC CurrentSince Aug 1, 2014 Accepting new patients
DLP Western Carolina Physician Practices LLC Surgery CurrentSince Aug 1, 2014 Accepting new patients
Integrated Wound Specialists of North Carolina, PLLC Surgery CurrentSince Mar 1, 2021 Accepting new patients
Cherokee Indian Hospital Authority Past Accepting new patients

Locations

5220 Belfort Rd
Ste 130
Jacksonville, FL 32256
Phone (904) 446-3686

40 Brettwood Trce
Clyde, NC 28721
Phone (828) 452-3110

35 Memorial Dr
Pinehurst, NC 28374
Phone (910) 715-3376

98 Doctors Dr
Ste 320
Sylva, NC 28779
Phone (828) 586-3976

37 Medical Park Loop
Ste 103
Sylva, NC 28779
Phone (828) 586-3976

37 Medical Park Loop
Ste 101
Sylva, NC 28779
Phone (828) 452-8346

98 Doctors Dr
Ste 200
Sylva, NC 28779
Phone (828) 586-8971

81 Medical Park Loop
Ste 202
Sylva, NC 28779
Phone (828) 586-5865

80 Healthcare Dr
Ste 203
Sylva, NC 28779
Phone (828) 586-5531

Interoperability endpoints

  • Direct secure messaging: eric.reitz.1@9865.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669075200000",
    "number": "1245220573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 BRETTWOOD TRCE",
            "city": "CLYDE",
            "state": "NC",
            "postal_code": "287218021",
            "telephone_number": "828-456-8633",
            "fax_number": "828-452-2792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 BRETTWOOD TRCE",
            "city": "CLYDE",
            "state": "NC",
            "postal_code": "287218021",
            "telephone_number": "828-456-8633",
            "fax_number": "828-452-2792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REITZ",
        "first_name": "ERIC",
        "middle_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-27",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "94-00992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8971211",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clyde, NC

Sources for this page

Verify at the official NPI Registry.