Active NPI
Breanna Reyes, MS, ATC, CEAS, CES
- Athletic Trainer
- West Columbia, SC
National Provider Identifier
1720433121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 1930
- Practice address
- 1200 Saluda Chase Way
West Columbia, SC 29169-6057 - Phone
- (850) 209-7446
- NPI assigned
- May 4, 2016
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 1930 | SC | Primary |
| Athletic Trainer | 2255A2300X | AL3627 | FL |
Addresses
Primary practice location
1200 Saluda Chase Way
West Columbia, SC 29169-6057
Mailing address
1200 Saluda Chase Way
West Columbia, SC 29169-6057
Phone (850) 209-7446
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1930 | SC | MD | Physical Therapy Assistant |
| AL3627 | FL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1462320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1462320000000",
"number": "1720433121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 SALUDA CHASE WAY",
"city": "WEST COLUMBIA",
"state": "SC",
"postal_code": "291696057",
"telephone_number": "850-209-7446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 SALUDA CHASE WAY",
"city": "WEST COLUMBIA",
"state": "SC",
"postal_code": "291696057",
"telephone_number": "850-209-7446"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYES",
"first_name": "BREANNA",
"credential": "MS, ATC, CEAS, CES",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-04",
"last_updated": "2016-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "SC",
"license": "1930",
"primary": true
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "FL",
"license": "AL3627",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.