Individual provider Active NPI

Vania Ling Reyes, M.D.

  • Internal Medicine Physician
  • St Petersburg, FL
National Provider Identifier
1598031635
Registry record updated Nov 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME123851 Issued in FL
Practice address
560 Jackson St N
Suite 302
St Petersburg, FL 33705-1449
Phone
(727) 895-9640
Fax
(727) 895-9645
NPI assigned
Mar 22, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X ME123851 FL Primary

Addresses

Primary practice location

560 Jackson St N
Suite 302
St Petersburg, FL 33705-1449

Mailing address

PO Box 10744
Clearwater, FL 33757-8744
Phone (727) 532-0002

Other identifiers 1

IdentifierTypeStateIssuer
019016600MedicaidFL

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME123851FLMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1332374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480377600000",
    "number": "1598031635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10744",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337578744",
            "telephone_number": "727-532-0002",
            "fax_number": "727-266-4943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 JACKSON ST N",
            "address_2": "SUITE 302",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337051449",
            "telephone_number": "727-895-9640",
            "fax_number": "727-895-9645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "VANIA",
        "middle_name": "LING",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-22",
        "last_updated": "2016-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME123851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019016600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.