NPIMap

Individual provider Active NPI

Jeffrey S. Reid, M.D.

  • Pulmonary Disease Physician
  • Carrollton, GA
National Provider Identifier
1639104748
Registry record updated Sep 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
055792 Issued in GA
Practice address
100 Professional Park
Suite 204
Carrollton, GA 30117-3874
Phone
(770) 834-3351
Fax
(770) 830-1518
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 055792 GA
Pulmonary Disease Physician 207RP1001X 055792 GA Primary
Sleep Medicine (Internal Medicine) Physician 207RS0012X 055792 GA

Addresses

Primary practice location

100 Professional Park
Suite 204
Carrollton, GA 30117-3874

Mailing address

100 Professional Park
Suite 204
Carrollton, GA 30117-3874
Phone (770) 834-3351

Other identifiers 1

IdentifierTypeStateIssuer
H80159OtherGAUPIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050927000830 GA Practitioner - Sleep MedicinePractitioner - Internal MedicinePractitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 0547295768 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sleep MedicineAlso: Critical Care (Intensivists), Pulmonary Disease
Education
Mercer University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Care Group of West GeorgiaGroup PAC ID 6709772197, 9 clinicians

Practice addresses (Care Compare)

100 Professional PL
Suite 204
Carrollton, GA 30117-3802
Phone (770) 834-3351

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
055792GAMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care Group of West Georgia Pulmonary Disease CurrentSince Jun 1, 2007 Accepting new patients

Locations

705 Dixie St
Carrollton, GA 30117
Phone (770) 812-9666

100 Professional Pl
Ste 204
Carrollton, GA 30117
Phone (770) 834-3351

Interoperability endpoints

  • Direct secure messaging: jreid@pcgofwestga.gwaydirect.com

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 and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348012800000",
    "number": "1639104748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PROFESSIONAL PARK",
            "address_2": "SUITE 204",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173874",
            "telephone_number": "770-834-3351",
            "fax_number": "770-830-1518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PROFESSIONAL PARK",
            "address_2": "SUITE 204",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173874",
            "telephone_number": "770-834-3351",
            "fax_number": "770-830-1518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REID",
        "first_name": "JEFFREY",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2012-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "GA",
            "license": "055792",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "GA",
            "license": "055792",
            "primary": true
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "GA",
            "license": "055792",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "H80159",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, GA

Sources for this page

Verify at the official NPI Registry.