Active NPI
Derek Clark Reeves Jr., P.A.
- Physician Assistant
- Waianae, HI
National Provider Identifier
1376793851
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- AMD 314
- Practice address
- 86-260 Farrington Highway
Waianae Coast Comprehensive Health Center Ed
Waianae, HI 96792-3199 - Phone
- (808) 697-3499
- NPI assigned
- Sep 22, 2008
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | AMD 314 | HI | Primary |
Addresses
Primary practice location
86-260 Farrington Highway
Waianae Coast Comprehensive Health Center Ed
Waianae, HI 96792-3199
Mailing address
86-260 Farrington Hwy
Waianae, HI 96792-3128
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AMD 314 | HI | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444262400000",
"number": "1376793851",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "86-260 FARRINGTON HWY",
"city": "WAIANAE",
"state": "HI",
"postal_code": "967923128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "86-260 FARRINGTON HIGHWAY",
"address_2": "WAIANAE COAST COMPREHENSIVE HEALTH CENTER ED",
"city": "WAIANAE",
"state": "HI",
"postal_code": "967923199",
"telephone_number": "808-697-3499"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REEVES",
"first_name": "DEREK",
"middle_name": "CLARK",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-09-22",
"last_updated": "2015-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "HI",
"license": "AMD 314",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waianae, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.