Individual provider Active NPI

Jeffery Reese, D.O.

  • Obstetrics & Gynecology Physician
  • Nampa, ID
National Provider Identifier
1588084453
Registry record updated Jul 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
O-1141 Issued in ID
Practice address
4424 E Flamingo Ave
Ste 200
Nampa, ID 83687
Phone
(208) 302-1400
Fax
(208) 302-1455
NPI assigned
Apr 18, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X O-1141 ID Primary

Addresses

Primary practice location

4424 E Flamingo Ave
Ste 200
Nampa, ID 83687

Mailing address

3340 E Goldstone Way
Meridian, ID 83642
Phone (208) 302-1400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20180706000531 ID Practitioner - Obstetrics/Gynecology 0042529703 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Jan 29, 2019 Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Jan 29, 2019 Accepting new patients
Saint Alphonsus Medical Center Nampa, Inc. CurrentSince Jan 29, 2019 Accepting new patients
Saint Alphonsus Regional Medical Center Inc Obstetrics & Gynecology Past Accepting new patients
Saint Alphonsus Specialty Services Inc Obstetrics & Gynecology Past Accepting new patients

Locations

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

3340 E Goldstone Dr
Meridian, ID 83642
Phone (208) 302-9342

3025 W Cherry Ln
Meridian, ID 83642
Phone (208) 302-6400

3025 W Cherry Ln
Ste B
Meridian, ID 83642
Phone (208) 302-6400

4400 E Flamingo Ave
Ste 100
Nampa, ID 83687
Phone (208) 302-2200

4424 E Flamingo Ave
Ste 200
Nampa, ID 83687
Phone (208) 302-1400

Interoperability endpoints

  • Direct secure messaging: jreese1564352@direct.trinity-health.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1397779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531958400000",
    "number": "1588084453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 E GOLDSTONE WAY",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83642",
            "telephone_number": "208-302-1400",
            "fax_number": "208-302-1455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4424 E FLAMINGO AVE",
            "address_2": "STE 200",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "83687",
            "telephone_number": "208-302-1400",
            "fax_number": "208-302-1455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REESE",
        "first_name": "JEFFERY",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-18",
        "last_updated": "2018-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "ID",
            "license": "O-1141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

Verify at the official NPI Registry.