Organization Active NPI

Alice J. Reed, PA

  • Internal Medicine Physician
  • Jacksonville Beach, FL
National Provider Identifier
1720380280
Registry record updated Mar 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ALICE J. REED, PA
Practice address
357 11TH Ave S
Jacksonville Beach, FL 32250-5153
Phone
(904) 249-6556
Fax
(904) 270-2263
NPI assigned
Dec 3, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2011

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

Authorized official

Name
Kandy Pariseau
Title
Office Manager
Phone
(904) 249-6556

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

357 11TH Ave S
Jacksonville Beach, FL 32250-5153

Mailing address

357 11TH Ave S
Jacksonville Beach, FL 32250-5153
Phone (904) 249-6556

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110303000023 FL Part B Supplier - Clinic/Group Practice 2860674470 Receives reassigned benefits from 1 practitioner
Practice locations: Jacksonville Beach, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0969365Alice J Reed PA357 11TH Ave S, Jacksonville Beach, FL 32250Certificate of waiverJan 11, 2028

National Provider Directory

National Provider Directory

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": "1291334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299024000000",
    "number": "1720380280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "357 11TH AVE S",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322505153",
            "telephone_number": "904-249-6556",
            "fax_number": "904-270-2263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "357 11TH AVE S",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322505153",
            "telephone_number": "904-249-6556",
            "fax_number": "904-270-2263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALICE J. REED, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-03",
        "last_updated": "2011-03-02",
        "status": "A",
        "authorized_official_last_name": "PARISEAU",
        "authorized_official_first_name": "KANDY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "904-249-6556"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.