Individual provider Active NPI

Chad David Reaves, DO

  • Internal Medicine Physician
  • Fairhope, AL
National Provider Identifier
1356447528
Registry record updated Jun 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DO.1567 Issued in AL
Practice address
188 Hospital Dr Ste 402
Fairhope, AL 36532-2018
Phone
(251) 990-1740
Fax
(251) 990-1831
NPI assigned
Sep 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DO.1567 AL Primary
Physician Assistant 363A00000X PA-463 AL

Addresses

Primary practice location

188 Hospital Dr Ste 402
Fairhope, AL 36532-2018

Mailing address

PO Box 2867
Mobile, AL 36652-2867
Phone (251) 690-8158

Other identifiers 1

IdentifierTypeStateIssuer
512-04537OtherALBCBS OF AL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20180517002848 AL Practitioner - Internal Medicine 0143373027 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Imc-Hospitalists LLCGroup PAC ID 2264727155, 83 clinicians

Practice addresses (Care Compare)

5 Mobile Infirmary Cir
Mobile, AL 36607-3513
Phone (251) 435-7289

750 Morphy Ave
Fairhope, AL 36532-1812
Phone (251) 435-7289

Hospital & facility affiliations

  • Thomas Hospital Hospital, Fairhope, AL, CCN 010100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO.1567ALMDInternal Medicine Physician
PA-463ALMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Park OBGYN PC CurrentSince Mar 19, 2018 Accepting new patients
Imc-Hospitalists LLC CurrentSince Aug 1, 2019 Accepting new patients
Inpatient Consultants of Alabama, Inc Internal Medicine CurrentSince Oct 15, 2017 Accepting new patients
Gulf Health Hospitals, Inc Past Accepting new patients
Sacred Heart Health System, Inc. Past Accepting new patients

Locations

750 Morphy Ave
Fairhope, AL 36532
Phone (251) 928-2375

150 S Ingleside St
#6
Fairhope, AL 36532
Phone (251) 928-1222

5 Mobile Infirmary Cir
Mobile, AL 36607
Phone (251) 432-4415

1725 Spring Hill Ave
Mobile, AL 36604
Phone (251) 435-1366

Interoperability endpoints

  • Direct secure messaging: creaves70986@directinfirmaryhealth.org

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561680000000",
    "number": "1356447528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2867",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366522867",
            "telephone_number": "251-690-8158",
            "fax_number": "251-690-8853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "188 HOSPITAL DR STE 402",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365322018",
            "telephone_number": "251-990-1740",
            "fax_number": "251-990-1831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REAVES",
        "first_name": "CHAD",
        "middle_name": "DAVID",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2019-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "DO.1567",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "PA-463",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF AL",
            "identifier": "512-04537",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairhope, AL

Sources for this page

Verify at the official NPI Registry.