Individual provider Active NPI

Miles C Reece III, DO

  • Emergency Medicine Physician
  • Sikeston, MO
National Provider Identifier
1457486870
Registry record updated Jun 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
R9F54 Issued in MO
Practice address
112 Plaza Dr
Sikeston, MO 63801-5137
Phone
(573) 472-6576
Fax
(573) 472-5307
NPI assigned
Feb 23, 2007
Last updated
Jun 21, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X R9F54 MO Primary
Family Medicine Physician 207Q00000X R9F54 MO

Addresses

Primary practice location

112 Plaza Dr
Sikeston, MO 63801-5137

Mailing address

112 Plaza Dr
Sikeston, MO 63801-5137
Phone (573) 472-6576

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120119000862 MO Practitioner - Emergency MedicinePractitioner - Family Practice 1658548391 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
State of Missouri Family Medicine Current Accepting new patients
State of Missouri CurrentSince Dec 13, 2011 Accepting new patients
State of Missouri Emergency Medicine CurrentSince Dec 13, 2011 Accepting new patients

Locations

2351 Kanell Blvd
Poplar Bluff, MO 63901
Phone (573) 840-9300

112 Plaza Dr
Sikeston, MO 63801
Phone (573) 472-5300

Organizations & group practices 3

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": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308614400000",
    "number": "1457486870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 PLAZA DR",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638015137",
            "telephone_number": "573-472-6576",
            "fax_number": "573-472-5307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 PLAZA DR",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638015137",
            "telephone_number": "573-472-6576",
            "fax_number": "573-472-5307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REECE",
        "first_name": "MILES",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-23",
        "last_updated": "2011-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "R9F54",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "R9F54",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sikeston, MO

Sources for this page

Verify at the official NPI Registry.