Robert Henry Reeder, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

ME122706 Issued in FL

Practice address

970 N 5TH Ave
St Charles, IL 60174-1227

Phone

(630) 584-1950

NPI assigned

Oct 20, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Florida Department of Health

  • Public Health or Welfare Agency
  • Starke, FL
  • NPI 1932174240
  Medicare reassignment NPD
• Fifth Ave Primary Care Physicians SC

  • Family Medicine Physician
  • St Charles, IL
  • NPI 1215029467
  NPD (past)

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460592000000",
    "number": "1336138486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 BROTHER GEENEN WAY",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342367102",
            "telephone_number": "630-584-1950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "970 N 5TH AVE",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601741227",
            "telephone_number": "630-584-1950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REEDER",
        "first_name": "ROBERT",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2016-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME122706",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "LL742",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1336138486",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rosa Raya, INTERPRETER
• Rci (WRS), LLC
• Jasmine Adawn Rebuck, LCSW
• Jeremiah Recinos, RBT
• Katherine Lynn Reed, LCSW
• Andrea Reffett
• Anna Linn Reinke, P.A.
• Lance David Reinke, PSY.D.
• Reliant DME LLC
• Ralph E. Remus, D.D.S.

• General Practice Physician in St Charles, IL
• Providers in St Charles, IL by specialty
• General Practice Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.