NPIMap

Organization Active NPI

Reed I. Ward, D.O., P.a.

  • Family Medicine Physician
  • Idaho Falls, ID
National Provider Identifier
1306044599
Registry record updated Feb 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
O-263 Issued in ID
Legal business name
REED I. WARD, D.O., P.A.
Practice address
3425 Potomac Way
Idaho Falls, ID 83404-4984
Phone
(208) 528-8170
Fax
(208) 522-5461
NPI assigned
Jul 10, 2007
Last updated
Feb 24, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2020

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

Authorized official

Name
Reed Ivol Ward, D.O.NPI 1235217506
Title
Owner
Phone
(208) 528-8170

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X O-263 ID Primary

Addresses

Primary practice location

3425 Potomac Way
Idaho Falls, ID 83404-4984

Mailing address

3360 Washington Pkwy Ste 2
Idaho Falls, ID 83404-8333
Phone (208) 528-8170

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120125000968 ID Part B Supplier - Clinic/Group Practice 9931158805 Receives reassigned benefits from 9 practitioners
Practice locations: Idaho Falls, ID

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582502400000",
    "number": "1306044599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3360 WASHINGTON PKWY STE 2",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834048333",
            "telephone_number": "208-528-8170",
            "fax_number": "208-522-5461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3425 POTOMAC WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834044984",
            "telephone_number": "208-528-8170",
            "fax_number": "208-522-5461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REED I. WARD, D.O., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-10",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "REED",
        "authorized_official_middle_name": "IVOL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-528-8170",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "O-263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.