Individual provider Active NPI

Gene G Reister, DPM

  • Foot & Ankle Surgery Podiatrist
  • Richardson, TX
National Provider Identifier
1659470896
Registry record updated Aug 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
DP1436 Issued in TX
Practice address
2001 N Collins Blvd
Ste 103
Richardson, TX 75080-2636
Phone
(972) 690-5374
Fax
(972) 690-6446
NPI assigned
Sep 22, 2006
Last updated
Aug 12, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X DP1436 TX Primary

Addresses

Primary practice location

2001 N Collins Blvd
Ste 103
Richardson, TX 75080-2636

Mailing address

2001 N Collins Blvd
Ste 103
Richardson, TX 75080-2636
Phone (972) 690-5374

Other identifiers 1

IdentifierTypeStateIssuer
018663701MedicaidTX

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

State licenses

LicenseStateTypeSpecialty
611TXMDMarriage & Family Therapist
DP1436TXMDFoot & Ankle Surgery Podiatrist

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250035200000",
    "number": "1659470896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 N COLLINS BLVD",
            "address_2": "STE 103",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750802636",
            "telephone_number": "972-690-5374",
            "fax_number": "972-690-6446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 N COLLINS BLVD",
            "address_2": "STE 103",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750802636",
            "telephone_number": "972-690-5374",
            "fax_number": "972-690-6446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISTER",
        "first_name": "GENE",
        "middle_name": "G",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2009-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "TX",
            "license": "DP1436",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018663701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2009; 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.