Active NPI
William Andrew Reese, MD
- Family Medicine Physician
- Daytona Beach, FL
National Provider Identifier
1720073547
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- ME157057
- Practice address
- 1 Aerospace Blvd
Daytona Beach, FL 32114-3910 - Phone
- (386) 226-7917
- NPI assigned
- Sep 19, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 0101047986 | VA | |
| Family Medicine Physician | 207Q00000X | ME157057 | FL | Primary |
Addresses
Primary practice location
1 Aerospace Blvd
Daytona Beach, FL 32114-3910
Mailing address
3585 Maribella Dr
New Smyrna Beach, FL 32168-5331
Phone (540) 220-8083
Other practice location 1
10620 Spotsylvania Ave
Fredericksburg, VA 22408
Phone (540) 710-1086
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 005854679 | Medicaid | VA | |
| 49D1807406 | Other | VA | CLIA |
| DD9150 | Other | MEDICARE RAILROAD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120309000396 | VA | Practitioner - General Practice | 3476596560 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME157057 | FL | MD | Family Medicine Physician |
| 0101047986 | VA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Reese Medical Associates | Current | Accepting new patients |
Locations
10620 Spotsylvania Ave
Fredericksburg, VA 22408
Phone (540) 374-3150
Interoperability endpoints
- wreese12045@marywashingtonhealthcare.direct-ci.com
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 and National Provider Directory roles.
-
- Primary Care Clinic/Center
- Fredericksburg, VA
- NPI 1538205521
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695600000000",
"number": "1720073547",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3585 MARIBELLA DR",
"city": "NEW SMYRNA BEACH",
"state": "FL",
"postal_code": "321685331",
"telephone_number": "540-220-8083"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 AEROSPACE BLVD",
"city": "DAYTONA BEACH",
"state": "FL",
"postal_code": "321143910",
"telephone_number": "386-226-7917"
}
],
"practiceLocations": [
{
"address_1": "10620 Spotsylvania Ave",
"address_purpose": "LOCATION",
"city": "Fredericksburg",
"state": "VA",
"postal_code": "22408",
"country_code": "US",
"telephone_number": "540-710-1086",
"fax_number": "540-710-1126",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "REESE",
"first_name": "WILLIAM",
"middle_name": "ANDREW",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-19",
"last_updated": "2023-09-25",
"certification_date": "2023-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "VA",
"license": "0101047986",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "ME157057",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "005854679",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CLIA",
"identifier": "49D1807406",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "DD9150",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Daytona Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; 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.