Individual provider Active NPI

Krissi Reeber, PA-C

  • Physician Assistant
  • Winter Park, FL
National Provider Identifier
1326362039
Registry record updated Oct 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 9105313 Issued in FL
Practice address
111 N Lakemont Ave
Suite 2-D
Winter Park, FL 32792-3213
Phone
(407) 622-2030
Fax
(407) 622-2033
NPI assigned
Mar 24, 2010
Last updated
Oct 27, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA 9105313 FL Primary

Addresses

Primary practice location

111 N Lakemont Ave
Suite 2-D
Winter Park, FL 32792-3213

Mailing address

111 N Lakemont Ave
Suite 2-D
Winter Park, FL 32792-3213
Phone (407) 622-2030

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)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA 9105313FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Central Florida Cardiology Group PA Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25476/brand/1/csg/1/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1269388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382832000000",
    "number": "1326362039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N LAKEMONT AVE",
            "address_2": "SUITE 2-D",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327923213",
            "telephone_number": "407-622-2030",
            "fax_number": "407-622-2033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N LAKEMONT AVE",
            "address_2": "SUITE 2-D",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327923213",
            "telephone_number": "407-622-2030",
            "fax_number": "407-622-2033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REEBER",
        "first_name": "KRISSI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-24",
        "last_updated": "2013-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA 9105313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2013; 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.