Individual provider Active NPI

Douglas Alan Reid, DPM

  • Podiatrist
  • Middletown, RI
National Provider Identifier
1467477224
Registry record updated Oct 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
DPM00276 Issued in RI
Practice address
850 Aquidneck Ave
Box 15
Middletown, RI 02842
Phone
(401) 849-2157
Fax
(401) 848-8441
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X DPM00276 RI Primary

Addresses

Primary practice location

850 Aquidneck Ave
Box 15
Middletown, RI 02842

Mailing address

850 Aquidneck Ave
Box 15
Middletown, RI 02842
Phone (401) 738-7750

Other identifiers 1

IdentifierTypeStateIssuer
DR12048MedicaidRI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180821001392 RI Order and Referring Only - PodiatryPractitioner - Podiatry 9032011994

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
276RIMDMental Health Counselor
DPM00276RIMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Foot and Ankle, LLC Podiatrist Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20650/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319673600000",
    "number": "1467477224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 AQUIDNECK AVE",
            "address_2": "BOX 15",
            "city": "MIDDLETOWN",
            "state": "RI",
            "postal_code": "02842",
            "telephone_number": "401-738-7750",
            "fax_number": "401-738-9750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 AQUIDNECK AVE",
            "address_2": "BOX 15",
            "city": "MIDDLETOWN",
            "state": "RI",
            "postal_code": "02842",
            "telephone_number": "401-849-2157",
            "fax_number": "401-848-8441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REID",
        "first_name": "DOUGLAS",
        "middle_name": "ALAN",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2011-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "RI",
            "license": "DPM00276",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DR12048",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, RI

Sources for this page

Verify at the official NPI Registry.