Barbara Nyce Reesor, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9108107 Issued in FL

Practice address

115 S Gloria St
Clewiston, FL 33440-3505

Phone

(863) 983-2282

Fax

(863) 983-2864

NPI assigned

Aug 29, 2014

Last updated

Aug 29, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1409270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409270400000",
    "number": "1750781480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 S GLORIA ST",
            "city": "CLEWISTON",
            "state": "FL",
            "postal_code": "334403505",
            "telephone_number": "863-983-2282",
            "fax_number": "863-983-2864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 S GLORIA ST",
            "city": "CLEWISTON",
            "state": "FL",
            "postal_code": "334403505",
            "telephone_number": "863-983-2282",
            "fax_number": "863-983-2864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYCE REESOR",
        "first_name": "BARBARA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-29",
        "last_updated": "2014-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9108107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL LICENSE NUMBER",
            "identifier": "PA9108107",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Medical Physician Assistant in Clewiston, FL
• Providers in Clewiston, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2014; 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.