Individual provider Active NPI

Lindsay Marie Reeves, FNP-C

  • Family Nurse Practitioner
  • Coos Bay, OR
National Provider Identifier
1336895556
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
202201525NP Issued in OR
Practice address
1957 Thompson Rd Ste G
Coos Bay, OR 97420-2040
Phone
(541) 404-6848
Fax
(541) 982-7283
NPI assigned
Feb 25, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obesity Medicine (Preventive Medicine) Physician 2083B0002X 202201525NP OR
Obesity Medicine (Preventive Medicine) Physician 2083B0002X 202201525NP-PP OR
Family Nurse Practitioner 363LF0000X 202201525NP OR Primary

Addresses

Primary practice location

1957 Thompson Rd Ste G
Coos Bay, OR 97420-2040

Mailing address

1957 Thompson Rd Ste G
Coos Bay, OR 97420-2040
Phone (541) 404-6848

Other practice location 1

1226 Virginia Ave
North Bend, OR 97459-2716
Phone (541) 305-4224

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220418001467 OR Practitioner - Nurse Practitioner 7214324425 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
202201525NPORMDObesity Medicine (Preventive Medicine) Physician
202201525NP-PPORMDObesity Medicine (Preventive Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icco, LLC CurrentSince Dec 20, 2022 Accepting new patients
Icco LLC CurrentSince Dec 20, 2022 Accepting new patients
Icco, LLC Current Accepting new patients

Locations

598 E 13th Ave
Eugene, OR 97401
Phone (541) 636-3473

1226 Virginia Ave
North Bend, OR 97459
Phone (541) 305-4224

Organizations & group practices 3

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": "1645747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1336895556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1957 THOMPSON RD STE G",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202040",
            "telephone_number": "541-404-6848",
            "fax_number": "541-982-7283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1957 THOMPSON RD STE G",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202040",
            "telephone_number": "541-404-6848",
            "fax_number": "541-982-7283"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1226 Virginia Ave",
            "address_purpose": "LOCATION",
            "city": "North Bend",
            "state": "OR",
            "postal_code": "974592716",
            "country_code": "US",
            "telephone_number": "541-305-4224",
            "fax_number": "541-305-4227",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REEVES",
        "first_name": "LINDSAY",
        "middle_name": "MARIE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-25",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083B0002X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Obesity Medicine",
            "state": "OR",
            "license": "202201525NP",
            "primary": false
        },
        {
            "code": "2083B0002X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Obesity Medicine",
            "state": "OR",
            "license": "202201525NP-PP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "202201525NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coos Bay, OR

Sources for this page

Verify at the official NPI Registry.