Individual provider Active NPI

William Andrew Reese, MD

  • Family Medicine Physician
  • Daytona Beach, FL
National Provider Identifier
1720073547
Registry record updated Sep 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME157057 Issued in FL
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

Updated by the provider on Sep 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
005854679MedicaidVA
49D1807406OtherVACLIA
DD9150OtherMEDICARE 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120309000396 VA Practitioner - General Practice 3476596560

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME157057FLMDFamily Medicine Physician
0101047986VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Reese Medical Associates Current Accepting new patients

Locations

10620 Spotsylvania Ave
Fredericksburg, VA 22408
Phone (540) 374-3150

Interoperability endpoints

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.