Individual provider Active NPI

Lori A Reaves, DO

  • Geriatric Medicine (Family Medicine) Physician
  • Hammonton, NJ
National Provider Identifier
1417959503
Registry record updated Nov 19, 2009
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128a(1) exclusion effective Feb 20, 2014.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
MBO64192 Issued in NJ
Practice address
640 North White Horse Pike
Hammonton, NJ 08037
Phone
(609) 567-9003
Fax
(609) 567-9269
NPI assigned
Jun 2, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X MBO64192 NJ Primary

Addresses

Primary practice location

640 North White Horse Pike
Hammonton, NJ 08037

Mailing address

640 North White Horse Pike
Hammonton, NJ 08037
Phone (609) 567-9003

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
MBO64192NJMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Visiting Physician Associates of South Jersey, LLC Past Accepting new patients
Visiting Physician Associates of South Jersey Geriatric Medicine Past Accepting new patients

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": "1117670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258588800000",
    "number": "1417959503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 NORTH WHITE HORSE PIKE",
            "city": "HAMMONTON",
            "state": "NJ",
            "postal_code": "08037",
            "telephone_number": "609-567-9003",
            "fax_number": "858-373-2478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 NORTH WHITE HORSE PIKE",
            "city": "HAMMONTON",
            "state": "NJ",
            "postal_code": "08037",
            "telephone_number": "609-567-9003",
            "fax_number": "609-567-9269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REAVES",
        "first_name": "LORI",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-02",
        "last_updated": "2009-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NJ",
            "license": "MBO64192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hammonton, NJ

Sources for this page

Verify at the official NPI Registry.