Christopher Lee Reardon, PH.D. M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

30050 Issued in CO

Practice address

650 E Indian School Rd
Carl T. Hayden VA Medical Center
Phoenix, AZ 85012-1839

Phone

(602) 277-5551

Fax

(602) 200-6005

NPI assigned

Jul 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487683298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 E INDIAN SCHOOL RD",
            "address_2": "CARL T. HAYDEN VA MEDICAL CENTER",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121839",
            "telephone_number": "602-277-5551",
            "fax_number": "602-200-6005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 E INDIAN SCHOOL RD",
            "address_2": "CARL T. HAYDEN VA MEDICAL CENTER",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121839",
            "telephone_number": "602-277-5551",
            "fax_number": "602-200-6005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REARDON",
        "first_name": "CHRISTOPHER",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "PH.D. M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CO",
            "license": "30050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0130008",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Real, RN
• Jennifer Renae Reale, NP
• Leah Reali, FNP
• Penny L Reamer, RN
• Ashley Reap
• Reassurance Healthcare
• Peter David Reaven, M.D.
• Bianca Reaves
• Mantriel A Reaves
• Christopher Ray Reavis, D.M.D

• Dermatology Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Dermatology Physician in Arizona

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.