Active NPI
Imee R. De Los Reyes, P.T.
- Physical Therapist
- Lafayette, IN
National Provider Identifier
1487808556
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 05003921A
- Practice address
- 300 Windy Hill Dr
Lafayette, IN 47905-2862 - Phone
- (765) 477-7791
- Fax
- (765) 474-2986
- NPI assigned
- Nov 15, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 05003921A | IN | Primary |
Addresses
Primary practice location
300 Windy Hill Dr
Lafayette, IN 47905-2862
Mailing address
300 Windy Hill Dr
Lafayette, IN 47905-2862
Phone (765) 477-7791
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05003921A | IN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1226707200000",
"number": "1487808556",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 WINDY HILL DR",
"city": "LAFAYETTE",
"state": "IN",
"postal_code": "479052862",
"telephone_number": "765-477-7791",
"fax_number": "765-474-2986"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 WINDY HILL DR",
"city": "LAFAYETTE",
"state": "IN",
"postal_code": "479052862",
"telephone_number": "765-477-7791",
"fax_number": "765-474-2986"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE LOS REYES",
"first_name": "IMEE",
"middle_name": "R.",
"name_prefix": "Mrs.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-11-15",
"last_updated": "2008-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05003921A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lafayette, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.