Individual provider Active NPI

Angela B Reese, M.D., P.C.

  • Pediatrics Physician
  • Toccoa, GA
National Provider Identifier
1265543060
Registry record updated Nov 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
047514 Issued in GA
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

Updated by the provider on Nov 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
000833049AMedicaidGA
336360OtherGAWELLCARE
G90082MedicaidSC
1005606OtherGAAMERIGROUP

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

LicenseStateTypeSpecialty
047514GAMDPediatrics Physician

Interoperability endpoints

  • Direct secure messaging: 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.

Verify at the official NPI Registry.