Organization Active NPI

Thomas K. Reid, M.D., Prof. Corp.

  • Ophthalmology Physician
  • Bishop, CA
National Provider Identifier
1700895430
Registry record updated Jan 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A54353 Issued in CA
Legal business name
THOMAS K. REID, M.D., PROF. CORP.
Practice address
157 Pioneer LN
Bishop, CA 93514-2557
Phone
(760) 873-8686
Fax
(873) 873-5507
NPI assigned
Aug 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2014

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

Authorized official

Name
Mrs. Michelle Leigh Reid
Title
Billing Manager
Phone
(760) 873-8686

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X A54353 CA Primary

Addresses

Primary practice location

157 Pioneer LN
Bishop, CA 93514-2557

Mailing address

157 Pioneer LN
Bishop, CA 93514-2557
Phone (760) 873-8686

Other identifiers 1

IdentifierTypeStateIssuer
00A543530MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070227000487 CA Part B Supplier - Clinic/Group Practice 4486756186 Receives reassigned benefits from 1 practitioner
Practice locations: Bishop, CA

National Provider Directory

National Provider Directory

Locations

157 Pioneer Ln
Bishop, CA 93514
Phone (760) 872-1606

214 W Line St
Ste C
Bishop, CA 93514
Phone (619) 873-8686

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390867200000",
    "number": "1700895430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "157 PIONEER LN",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "935142557",
            "telephone_number": "760-873-8686",
            "fax_number": "873-873-5507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "157 PIONEER LN",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "935142557",
            "telephone_number": "760-873-8686",
            "fax_number": "873-873-5507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS K. REID, M.D., PROF. CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2014-01-28",
        "status": "A",
        "authorized_official_last_name": "REID",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "LEIGH",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "760-873-8686",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A54353",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A543530",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bishop, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.