Active NPI
Ferrel Mearl Reid Jr., BA
- Recreational Therapist Assistant
- Eureka, CA
National Provider Identifier
1356752265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Recreational Therapist Assistant
- Practice address
- 720 Wood St
Eureka, CA 95501-4413 - Phone
- (707) 268-2990
- Fax
- (707) 476-4061
- NPI assigned
- May 13, 2014
- Last updated
- Jan 5, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Recreational Therapist Assistant | 226000000X | NU | Primary |
Addresses
Primary practice location
720 Wood St
Eureka, CA 95501-4413
Mailing address
1402 Clam Beach Rd
McKinleyville, CA 95519-9487
Phone (707) 267-4610
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)
- Not enrolled
- Credentials
- Bachelor of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1399939200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578182400000",
"number": "1356752265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1402 CLAM BEACH RD",
"city": "MCKINLEYVILLE",
"state": "CA",
"postal_code": "955199487",
"telephone_number": "707-267-4610"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "720 WOOD ST",
"city": "EUREKA",
"state": "CA",
"postal_code": "955014413",
"telephone_number": "707-268-2990",
"fax_number": "707-476-4061"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REID",
"first_name": "FERREL",
"middle_name": "MEARL",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "BA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-05-13",
"last_updated": "2020-01-05",
"certification_date": "2020-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "226000000X",
"taxonomy_group": "",
"desc": "Recreational Therapist Assistant",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Eureka, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.