Active NPI
Michael Thane Reedy, M.D.
- Anatomic Pathology & Clinical Pathology Physician
- Medford, OR
National Provider Identifier
1730184417
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 16908
- Practice address
- 2825 E Barnett Rd
Medford, OR 97504-8332 - Phone
- (541) 789-4191
- Fax
- (541) 789-5942
- NPI assigned
- Jun 17, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 16908 | OR | Primary |
Addresses
Primary practice location
2825 E Barnett Rd
Medford, OR 97504-8332
Mailing address
PO Box 4235
Medford, OR 97501-0159
Phone (541) 789-4191
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16908 | OR | MD | Anatomic Pathology & Clinical Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1281657600000",
"number": "1730184417",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4235",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975010159",
"telephone_number": "541-789-4191",
"fax_number": "541-789-5942"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2825 E BARNETT RD",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975048332",
"telephone_number": "541-789-4191",
"fax_number": "541-789-5942"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REEDY",
"first_name": "MICHAEL",
"middle_name": "THANE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-17",
"last_updated": "2010-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "OR",
"license": "16908",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.