Individual provider Active NPI

Terry R. Reed, BOCPD

  • Pedorthist
  • Wynne, AR
National Provider Identifier
1427767136
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PedorthistTaxonomy code 224L00000X
License
OPP00273 Issued in AR
Practice address
804 Falls Blvd S
Wynne, AR 72396-3505
Phone
(870) 238-7085
Fax
(870) 587-0112
NPI assigned
Nov 21, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pedorthist 224L00000X OPP00273 AR Primary

Addresses

Primary practice location

804 Falls Blvd S
Wynne, AR 72396-3505

Mailing address

804 Falls Blvd S
Wynne, AR 72396-3505
Phone (870) 238-7085

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

State licenses

LicenseStateTypeSpecialty
OPP00273ARMDPedorthist

NPI Registry JSON

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

{
    "created_epoch": "1668988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1427767136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 FALLS BLVD S",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "723963505",
            "telephone_number": "870-238-7085",
            "fax_number": "870-587-0112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 FALLS BLVD S",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "723963505",
            "telephone_number": "870-238-7085",
            "fax_number": "870-587-0112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REED",
        "first_name": "TERRY",
        "middle_name": "R.",
        "credential": "BOCPD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-21",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224L00000X",
            "taxonomy_group": "",
            "desc": "Pedorthist",
            "state": "AR",
            "license": "OPP00273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wynne, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.