Individual provider Active NPI

Kristin E Reeves, PT, DPT,

  • Physical Therapist
  • Macon, GA
National Provider Identifier
1437439486
Registry record updated Jan 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT011672 Issued in GA
Practice address
3708 Northside Dr
Macon, GA 31210-2404
Phone
(478) 745-4206
Fax
(478) 254-5413
NPI assigned
Aug 23, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2015

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 PT011672 GA Primary

Addresses

Primary practice location

3708 Northside Dr
Macon, GA 31210-2404

Mailing address

3708 Northside Dr
Macon, GA 31210-2404
Phone (478) 745-4206

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150407002267 GA Practitioner - Physical Therapist in Private Practice 6800114638 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Georgia Neurosurgical Institute, P.CGroup PAC ID 7517958234, 22 clinicians

Practice addresses (Care Compare)

840 Pine St
Suite 880
Macon, GA 31201-7525
Phone (478) 743-7092

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT011672GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Neurosurgical Institute, P.C. CurrentSince Dec 29, 2017 Accepting new patients
Macon Orthopaedic & Hand Center, PA Physical Therapist Past Accepting new patients

Locations

840 Pine St
Ste 880
Macon, GA 31201
Phone (478) 743-7092

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1314057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421884800000",
    "number": "1437439486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3708 NORTHSIDE DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312102404",
            "telephone_number": "478-745-4206",
            "fax_number": "478-254-5413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3708 NORTHSIDE DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312102404",
            "telephone_number": "478-745-4206",
            "fax_number": "478-254-5413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REEVES",
        "first_name": "KRISTIN",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "PT, DPT,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-23",
        "last_updated": "2015-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT011672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2015; 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.