Active NPI
Jerry L Reams, LMP
- Contractor
- Vancouver, WA
National Provider Identifier
1275611501
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- MA00020315
- Practice address
- 1307B NE 78TH St.
Suite 3
Vancouver, WA 98665 - Phone
- (360) 573-1933
- Fax
- (360) 571-0143
- NPI assigned
- Nov 2, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Contractor | 171W00000X | MA00020315 | WA | Primary |
Addresses
Primary practice location
1307B NE 78TH St.
Suite 3
Vancouver, WA 98665
Mailing address
1307B NE 78TH St.
Suite 3
Vancouver, WA 98665
Phone (136) 057-3193
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA00020315 | WA | MD | Contractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| NW Injury & Rehab Center, P.S. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Rehabilitation Chiropractor
- Vancouver, WA
- NPI 1619295524
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1275611501",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1307B NE 78TH ST.",
"address_2": "SUITE 3",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "98665",
"telephone_number": "136-057-3193",
"fax_number": "136-057-1014"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1307B NE 78TH ST.",
"address_2": "SUITE 3",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "98665",
"telephone_number": "360-573-1933",
"fax_number": "360-571-0143"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REAMS",
"first_name": "JERRY",
"middle_name": "L",
"name_prefix": "Mr.",
"credential": "LMP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "WA",
"license": "MA00020315",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.