Individual provider Active NPI

William J Reedy, MD

  • Family Medicine Physician
  • Mesa, AZ
National Provider Identifier
1346210341
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
16164 Issued in AZ
Practice address
1111 N Stapley Dr
Mesa, AZ 85203-4903
Phone
(480) 464-8500
NPI assigned
Jan 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 16164 AZ Primary

Addresses

Primary practice location

1111 N Stapley Dr
Mesa, AZ 85203-4903

Mailing address

1111 N Stapley Dr
Mesa, AZ 85203-4903
Phone (480) 464-8500

Other identifiers 1

IdentifierTypeStateIssuer
271411MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20040525001694 AZ Practitioner - General Practice 5092796110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
16164AZMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cigna Health Care of Arizona Inc Current Accepting new patients
Cigna Healthcare of Arizona, Inc. CurrentSince Jul 1, 1986 Accepting new patients
Cigna Health Care of Arizona Inc. Current Accepting new patients
Cigna Health Care of Arizona Inc. Current Accepting new patients
Cigna Healthcare of Arizona, Inc. CurrentSince Jul 1, 1986 Accepting new patients

Locations

1717 W Chandler Blvd
Chandler, AZ 85224
Phone (480) 281-7565

4001 E Baseline Rd
Ste 107
Gilbert, AZ 85234
Phone (480) 532-4060

5891 W Eugie Ave
Glendale, AZ 85304
Phone (602) 588-6600

1840 S Stapley Dr
Ste 101
Mesa, AZ 85204
Phone (480) 464-8500

1300 N 12th St
Ste 404
Phoenix, AZ 85006
Phone (602) 839-7000

3003 N 3rd St
Phoenix, AZ 85012
Phone (602) 282-9800

8888 E Raintree Dr
Ste 300
Scottsdale, AZ 85260
Phone (602) 328-8400

8888 E Raintree Dr
Fl 3
Scottsdale, AZ 85260

13991 W Grand Ave
Ste 105
Surprise, AZ 85374
Phone (623) 455-7800

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346210341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 N STAPLEY DR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852034903",
            "telephone_number": "480-464-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 N STAPLEY DR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852034903",
            "telephone_number": "480-464-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REEDY",
        "first_name": "WILLIAM",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "16164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271411",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.