Active NPI
Edisley Reyes, RN
- Registered Nurse
- Louisville, KY
National Provider Identifier
1306620349
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 1167486
- Practice address
- 901 S 4TH St
Louisville, KY 40203-3205 - Phone
- (502) 585-9911
- NPI assigned
- Aug 21, 2023
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 1167486 | KY | Primary |
Addresses
Primary practice location
901 S 4TH St
Louisville, KY 40203-3205
Mailing address
901 S 4TH St
Louisville, KY 40203-3205
Phone (502) 585-9911
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
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1167486 | KY | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692576000000",
"number": "1306620349",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "901 S 4TH ST",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402033205",
"telephone_number": "502-585-9911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 S 4TH ST",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402033205",
"telephone_number": "502-585-9911"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYES",
"first_name": "EDISLEY",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-08-21",
"last_updated": "2023-08-21",
"certification_date": "2023-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "KY",
"license": "1167486",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.