Johnathan Brett Reddick, APRN, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5021066 Issued in NC

Practice address

1123 N Church St
Greensboro, NC 27401-1007

Phone

(336) 832-4400

NPI assigned

Mar 14, 2022

Last updated

Oct 30, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI, NC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Moses H Cone Memorial Hospital Operating CorporationGroup PAC ID 6204744600, 724 clinicians

Alamance Regional Medical Center IncGroup PAC ID 5294647145, 71 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Moses H. Cone Memorial Hospital, the Hospital, Greensboro, NC, CCN 340091

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jreddick299908@direct.myadvocateaurora.org

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.

• Alamance Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Burlington, NC
  • NPI 1326010273
  Medicare reassignment Care Compare group NPD
• The Moses H. Cone Memorial Hospital Operating Corporation

  dba Cone Health Sickle Cell Center

  • Internal Medicine Physician
  • Greensboro, NC
  • NPI 1013265909
  Medicare reassignment Care Compare group NPD
• Alamance Regional Medical Center, Inc

  dba ARMC Health Care Employee Pharmacy

  • Pharmacy
  • Burlington, NC
  • NPI 1851681993
  NPD
• The Moses H Cone Memorial Hospital Operating Corporation

  • Internal Medicine Physician
  • Greensboro, NC
  • NPI 1356372064
  NPD
• The Moses H Cone Memorial Hospital Operating Corporation

  dba Cone Health Community Pharmacy at Eden

  • Community/Retail Pharmacy
  • Eden, NC
  • NPI 1861222507
  NPD
• The Moses H. Cone Memorial Hospital Operating Corporation

  dba Center for Maternal Fetal Care

  • Maternal & Fetal Medicine Physician
  • Greensboro, NC
  • NPI 1891351847
  NPD (past)

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

• The Moses H. Cone Memorial Hospital Operating Corporation

  • General Acute Care Hospital
  • Greensboro, NC
  • NPI 1477591055
  Care Compare affiliation

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

{
    "created_epoch": "1647216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1245988781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60673",
            "telephone_number": "262-251-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1123 N CHURCH ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011007",
            "telephone_number": "336-832-4400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "N84W16889 Menomonee Ave",
            "address_purpose": "LOCATION",
            "city": "Menomonee Falls",
            "state": "WI",
            "postal_code": "530512810",
            "country_code": "US",
            "telephone_number": "262-251-7500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "635 N Dearborn St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606544618",
            "country_code": "US",
            "telephone_number": "312-694-2273",
            "fax_number": "312-694-2129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REDDICK",
        "first_name": "JOHNATHAN",
        "middle_name": "BRETT",
        "credential": "APRN, CNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-14",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "101031-875",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209023782",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5021066",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100250920",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Tanya Donielle Redd, D.D.S.
• John Fulton Redding II, MD
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• Keshavpal G Reddy, M.D.
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• Redefined for Her

• Family Nurse Practitioner in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.