Individual provider Active NPI

Rodney David Reiber, PA

  • Physician Assistant
  • Panama City, FL
National Provider Identifier
1700829157
Registry record updated Dec 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9101186 Issued in FL
Practice address
449 W 23Rd St
Panama City, FL 32405-4507
Phone
(850) 747-7900
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9101186 FL Primary

Addresses

Primary practice location

449 W 23Rd St
Panama City, FL 32405-4507

Mailing address

PO Box 11317
Daytona Beach, FL 32120-1317
Phone (386) 274-7800

Other identifiers 1

IdentifierTypeStateIssuer
292460900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050422000638 FL Practitioner - Physician Assistant 1759329360 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
FL-I Medical Services LLC Physician Assistant CurrentSince Jul 1, 2016 Accepting new patients
FL-I Medical Services, LLC Physician Assistant CurrentSince Jul 1, 2016 Accepting new patients
Blue Wave Emergency Physicians LLC Past Accepting new patients
Gulf Emergency Specialists PA Past Accepting new patients

Locations

322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858

996 Airport Rd
Destin, FL 32541
Phone (615) 338-1250

1700 S 23rd St
Fort Pierce, FL 34950
Phone (772) 461-4000

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

449 W 23rd St
Panama City, FL 32405
Phone (850) 747-7900

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640736000000",
    "number": "1700829157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11317",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321201317",
            "telephone_number": "386-274-7800",
            "fax_number": "386-274-7801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "449 W 23RD ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054507",
            "telephone_number": "850-747-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REIBER",
        "first_name": "RODNEY",
        "middle_name": "DAVID",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9101186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "292460900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.