NPIMap

Individual provider Active NPI

Calvin L. Reid, MD

  • Internal Medicine Physician
  • Dothan, AL
National Provider Identifier
1720081888
Registry record updated Sep 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
9359 Issued in AL
Practice address
210 Westside Dr
Dothan, AL 36303-1928
Phone
(334) 793-5074
Fax
(334) 793-6460
NPI assigned
May 23, 2005
Last updated
Sep 23, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 9359 AL Primary

Addresses

Primary practice location

210 Westside Dr
Dothan, AL 36303-1928

Mailing address

210 Westside Dr
Dothan, AL 36303-1928
Phone (334) 793-5074

Other identifiers 2

IdentifierTypeStateIssuer
110082146OtherRAILROAD MEDICARE
000010471MedicaidAL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address calvin.reid.1@3326.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100428000455 AL Practitioner - Internal MedicinePractitioner - Geriatric Medicine 8022020130 Reassigns benefits to 1 organization
Practice locations: Dothan, AL

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
University of Alabama School of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wiregrass Clinic LLCGroup PAC ID 2860662491, 69 clinicians

Practice addresses (Care Compare)

210 Westside Dr
Dothan, AL 36303-1928
Phone (334) 793-5074

4300 W Main St
Dothan, AL 36305-1058

4300 W Main St
Suite 41
Dothan, AL 36305-1318
Phone (334) 615-8490

500 Healthwest Dr
Dothan, AL 36303-6900
Phone (334) 699-5994

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.97 of 100Reported as apm
Quality
75.95
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9359ALMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wiregrass Clinic LLC Internal Medicine CurrentSince Jun 1, 2013 Accepting new patients
Westside Terrace, LLC Past Accepting new patients
Calvin L. Reid Geriatric Services, LLC Past Accepting new patients

Locations

210 Westside Dr
Dothan, AL 36303
Phone (334) 793-5074

4300 W Main St
Ste 21
Dothan, AL 36305
Phone (334) 699-7900

4370 W Main St
Dothan, AL 36305
Phone (256) 332-1611

501 N Woodburn Dr
Dothan, AL 36303
Phone (334) 793-5074

Interoperability endpoints

  • Direct secure messaging: calvin.reid.3@3326.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Westside Terrace Health & Rehabilitation CenterDothan, AL, CCN 015425 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2010
Jan 1, 2010

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Westside Terrace, LLC

    dba Westside Terrace Health & Rehabilitation Center

    • Skilled Nursing Facility
    • Dothan, AL
    • NPI 1225012636

    Adp of the SNF, Operational/Managerial Control

    CMS ownership

Organizations & group practices 3

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600819200000",
    "number": "1720081888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 WESTSIDE DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363031928",
            "telephone_number": "334-793-5074",
            "fax_number": "334-793-6460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 WESTSIDE DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363031928",
            "telephone_number": "334-793-5074",
            "fax_number": "334-793-6460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REID",
        "first_name": "CALVIN",
        "middle_name": "L.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "9359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110082146",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000010471",
            "state": "AL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "calvin.reid.1@3326.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Athena AMR",
            "address_1": "210 Westside Dr",
            "city": "Dothan",
            "state": "AL",
            "country_code": "US",
            "postal_code": "363031928",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.