Individual provider Active NPI

Jordan Reed, PT, DPT

  • Physical Therapist
  • Indianapolis, IN
National Provider Identifier
1376941807
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05011583A Issued in IN
Practice address
8810 Colby Blvd
Indianapolis, IN 46268-1399
Phone
(317) 552-2186
NPI assigned
Dec 16, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05011583A IN Primary

Addresses

Primary practice location

8810 Colby Blvd
Indianapolis, IN 46268-1399

Mailing address

8810 Colby Blvd
Indianapolis, IN 46268-1399

Other practice location 1

3177 Meridian Parke Dr
Greenwood, IN 46142-9629
Phone (317) 859-2006

Other identifiers 1

IdentifierTypeStateIssuer
05011583AOtherININDIANA STATE PHYSICAL THERAPY LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220922002453 IN Practitioner - Physical Therapist in Private Practice 3072998343 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

7555 El Beulah Blvd
Indianapolis, IN 46256-2928
Phone 8552393467792

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05011583AINMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc Physical Therapist CurrentSince Aug 4, 2022 Accepting new patients
Legacy Healthcare Services, Inc. Physical Therapist CurrentSince Aug 4, 2022 Accepting new patients

Locations

7555 El Beulah Blvd
Indianapolis, IN 46256
Phone (317) 284-1893

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300

Organizations & group practices 2

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": "1418688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1376941807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8810 COLBY BLVD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462681399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8810 COLBY BLVD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462681399",
            "telephone_number": "317-552-2186"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3177 Meridian Parke Dr",
            "address_purpose": "LOCATION",
            "city": "Greenwood",
            "state": "IN",
            "postal_code": "461429629",
            "country_code": "US",
            "telephone_number": "317-859-2006",
            "fax_number": "317-859-2195",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REED",
        "first_name": "JORDAN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-16",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05011583A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA STATE PHYSICAL THERAPY LICENSE",
            "identifier": "05011583A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.