Active NPI
Reed I. Ward, D.O., P.a.
- Family Medicine Physician
- Idaho Falls, ID
National Provider Identifier
1306044599
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- O-263
- 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
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Reed Ivol Ward, D.O.
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 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
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000010138476 | Other | ID | REGENCE BLUE SHIELD OF ID |
| 8N464 | Other | ID | BLUE CROSS OF IDAHO |
| 080184962 | Other | ID | RAILROAD MEDICARE |
| 806385700 | Medicaid | ID |
Practitioners 11
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Idaho Falls, ID
- NPI 1376069724
Family Medicine, ID
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 DirectoryNPI 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": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUE SHIELD OF ID",
"identifier": "000010138476",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS OF IDAHO",
"identifier": "8N464",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "080184962",
"state": "ID"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "806385700",
"state": "ID"
}
],
"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.