Reginald Anderson, M.E.S. MEDICAL EXERC

Primary specialty

Clinical Exercise PhysiologistTaxonomy code 224Y00000X

License

V6RA26-12 Issued in IL

Practice address

328 Peterson Rd
Libertyville, IL 60048-1008

Phone

(847) 549-1705

NPI assigned

Oct 3, 2012

Last updated

Oct 3, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1349222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349222400000",
    "number": "1740532589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "328 PETERSON RD",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600481008",
            "telephone_number": "847-549-1705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "328 PETERSON RD",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600481008",
            "telephone_number": "847-549-1705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "REGINALD",
        "name_prefix": "Mr.",
        "credential": "M.E.S. MEDICAL EXERC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-03",
        "last_updated": "2012-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Y00000X",
            "taxonomy_group": "",
            "desc": "Clinical Exercise Physiologist",
            "state": "IL",
            "license": "V6RA26-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amg Endoscopy Center LTD
• Ali Amro, M.D.
• Nicole Amsberry, PTA
• Amy Zier & Megan Carrick Pediatric Therapy, LLC
• Kara Anast
• Ryan Anderson
• Sara Anderson
• Thomas McDowell Anderson, MD
• Jullyana Angeles
• Angelique Cohen M.D.S.C.

• Clinical Exercise Physiologist in Libertyville, IL
• Providers in Libertyville, IL by specialty
• Clinical Exercise Physiologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2012; 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.