Active NPI
Angela B Reese, M.D., P.C.
- Pediatrics Physician
- Toccoa, GA
National Provider Identifier
1265543060
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 047514
- Practice address
- 154 W Tugalo St
Toccoa, GA 30577-2360 - Phone
- (706) 886-1309
- Fax
- (706) 886-6132
- NPI assigned
- Aug 31, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 047514 | GA | Primary |
Addresses
Primary practice location
154 W Tugalo St
Toccoa, GA 30577-2360
Mailing address
PO Box 335
Toccoa, GA 30577-1405
Phone (706) 886-1309
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000833049A | Medicaid | GA | |
| 336360 | Other | GA | WELLCARE |
| G90082 | Medicaid | SC | |
| 1005606 | Other | GA | AMERIGROUP |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 047514 | GA | MD | Pediatrics Physician |
Interoperability endpoints
- abreesemd@okp-ga.direct.office.nextgen.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351728000000",
"number": "1265543060",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 335",
"city": "TOCCOA",
"state": "GA",
"postal_code": "305771405",
"telephone_number": "706-886-1309",
"fax_number": "706-886-6132"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "154 W TUGALO ST",
"city": "TOCCOA",
"state": "GA",
"postal_code": "305772360",
"telephone_number": "706-886-1309",
"fax_number": "706-886-6132"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REESE",
"first_name": "ANGELA",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "M.D., P.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-31",
"last_updated": "2012-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "GA",
"license": "047514",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000833049A",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE",
"identifier": "336360",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "G90082",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP",
"identifier": "1005606",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Toccoa, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.