Active NPI
Ryan Rene Reyes
- Independent Duty Medical Technicians
- Hurlburt Field, FL
National Provider Identifier
1447850268
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Independent Duty Medical Technicians
- Practice address
- 113 Lielmanis Ave
Hurlburt Field, FL 32544-5613 - Phone
- (850) 881-4680
- NPI assigned
- Oct 30, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Independent Duty Medical Technicians | 1710I1003X | Primary |
Addresses
Primary practice location
113 Lielmanis Ave
Hurlburt Field, FL 32544-5613
Mailing address
955 Tray Dr
Fort Walton Beach, FL 32547-4243
Phone (907) 651-2883
Other practice location 1
1 Somdg
113 Lielmanis Ave.
Hurlburt Field, FL 32544
Phone (850) 881-4680
Other practice location 2
340 Boatner Rd
Eglin AFB, FL 32542-1391
Phone (850) 883-8600
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ryan.r.reyes4.mil@mail.mil |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715212800000",
"number": "1447850268",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "955 TRAY DR",
"city": "FORT WALTON BEACH",
"state": "FL",
"postal_code": "325474243",
"telephone_number": "907-651-2883"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "113 LIELMANIS AVE",
"city": "HURLBURT FIELD",
"state": "FL",
"postal_code": "325445613",
"telephone_number": "850-881-4680"
}
],
"practiceLocations": [
{
"address_1": "1 SOMDG",
"address_2": "113 Lielmanis Ave.",
"address_purpose": "LOCATION",
"city": "Hurlburt Field",
"state": "FL",
"postal_code": "32544",
"country_code": "US",
"telephone_number": "850-881-4680",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "340 Boatner Rd",
"address_purpose": "LOCATION",
"city": "Eglin AFB",
"state": "FL",
"postal_code": "325421391",
"country_code": "US",
"telephone_number": "850-883-8600",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "REYES",
"first_name": "RYAN",
"middle_name": "RENE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-10-30",
"last_updated": "2024-05-09",
"certification_date": "2024-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "1710I1003X",
"taxonomy_group": "",
"desc": "Military Health Care Provider, Independent Duty Medical Technicians",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ryan.r.reyes4.mil@mail.mil",
"affiliation": "N",
"address_1": "1024 Nordale Rd",
"city": "North Pole",
"state": "AK",
"country_code": "US",
"postal_code": "997055154",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Hurlburt Field, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.