John Kenneth Reid, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2-1444 Issued in TX

Practice address

16414 San Pedro Ave
Suite 545
San Antonio, TX 78232-2277

Phone

(210) 495-7733

Fax

(210) 497-5450

NPI assigned

Jul 11, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Evergreen Elder Care, Inc.

  • Psychologist
  • San Antonio, TX
  • NPI 1578658639
  NPD (past)

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447285515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16414 SAN PEDRO AVE",
            "address_2": "SUITE 545",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782322277",
            "telephone_number": "210-495-7733",
            "fax_number": "210-497-5450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16414 SAN PEDRO AVE",
            "address_2": "SUITE 545",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782322277",
            "telephone_number": "210-495-7733",
            "fax_number": "210-497-5450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REID",
        "first_name": "JOHN",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "2-1444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail Leigh Reichow, DPT
• Joseph Charles Reicks, DO
• Bailey Reid, PHARMD
• Darryl Edward Reid Sr., RN
• Edward Reid
• Kaitlyn Nicole Reid, RBT
• Peggy Reid, RN
• Reginald Reid Jr., SRNA
• Cindy Ramos Reidinger, BCBA
• Rebecca Reidy

• Psychologist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.