Active NPI
Lawrence H Reid, MD
- Dermatology Physician
- Greeneville, TN
National Provider Identifier
1699760017
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- MD0000007105
- Practice address
- 1404 Tusculum Blvd
Ste 1100
Greeneville, TN 37745-4279 - Phone
- (423) 787-7020
- Fax
- (423) 787-7025
- NPI assigned
- Sep 12, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | MD0000007105 | TN | Primary |
Addresses
Primary practice location
1404 Tusculum Blvd
Ste 1100
Greeneville, TN 37745-4279
Mailing address
1404 Tusculum Blvd
Ste 1100
Greeneville, TN 37745-4279
Phone (423) 787-7020
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3046612 | Other | TN | BCBS # |
| 1539546 | Other | TN | UMWA # |
| 62166246601 | Other | TN | JOHN DEERE # |
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
| License | State | Type | Specialty |
|---|---|---|---|
| MD0000007105 | TN | MD | Dermatology Physician |
Interoperability endpoints
- lreid@directaddress.net
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Dermatology Physician
- Greeneville, TN
- NPI 1477624336
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1699760017",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1404 TUSCULUM BLVD",
"address_2": "STE 1100",
"city": "GREENEVILLE",
"state": "TN",
"postal_code": "377454279",
"telephone_number": "423-787-7020",
"fax_number": "423-787-7025"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1404 TUSCULUM BLVD",
"address_2": "STE 1100",
"city": "GREENEVILLE",
"state": "TN",
"postal_code": "377454279",
"telephone_number": "423-787-7020",
"fax_number": "423-787-7025"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REID",
"first_name": "LAWRENCE",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "TN",
"license": "MD0000007105",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS #",
"identifier": "3046612",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UMWA #",
"identifier": "1539546",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JOHN DEERE #",
"identifier": "62166246601",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Greeneville, TN
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.