Nicole Reid MD LLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

2007011080 Issued in MO

Legal business name

NICOLE REID MD LLC

Practice address

1015 State Highway 248
Suite B
Branson, MO 65616-8001

Phone

(417) 336-3646

Fax

(417) 336-3644

NPI assigned

Jun 10, 2010

Organization subpart

No

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

Authorized official

Name

Nicole L. Reid, M.D.

Title

Owner

Phone

(417) 336-3646

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1276128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316476800000",
    "number": "1730409913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 STATE HIGHWAY 248 STE Q-434",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656169655",
            "telephone_number": "417-336-3646",
            "fax_number": "417-336-3644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 STATE HIGHWAY 248",
            "address_2": "SUITE B",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656168001",
            "telephone_number": "417-336-3646",
            "fax_number": "417-336-3644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICOLE REID MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-10",
        "last_updated": "2011-09-20",
        "status": "A",
        "authorized_official_last_name": "REID",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "417-336-3646",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "MO",
            "license": "2007011080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Branson, MO
• Providers in Branson, MO by specialty
• Surgery Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.