Jeffrey Walter Reddout, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PY5052 Issued in FL

Practice address

400 Orchid Springs Dr
Winter Haven, FL 33884-1678

Phone

(863) 326-6419

Fax

(863) 326-5640

NPI assigned

Dec 5, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Winter Haven Hospital Inc

  • General Acute Care Hospital
  • Winter Haven, FL
  • NPI 1477599975
  Medicare reassignment NPD

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639237225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 ORCHID SPRINGS DR",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338841678",
            "telephone_number": "863-326-6419",
            "fax_number": "863-326-5640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 ORCHID SPRINGS DR",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338841678",
            "telephone_number": "863-326-6419",
            "fax_number": "863-326-5640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDOUT",
        "first_name": "JEFFREY",
        "middle_name": "WALTER",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY5052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raypar Inc (Pediatric Partners of WH)
• Raypar Inc (Owl Now Urgent Care)
• Raypar Inc (Trinity Medical Group)
• Ladia Reason
• Tori Vontrese Reddick, N/A
• Reddy Medical Care LLC
• Ashok G Reddy, M.D
• Sriya Vanga Reddy, DO
• Sarah Ann Reece
• Maricela M Reecy I, LCSW

• Clinical Neuropsychologist in Winter Haven, FL
• Providers in Winter Haven, FL by specialty
• Clinical Neuropsychologist in Florida

• 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.