Individual provider Active NPI

Johnny W Reed, PAC

  • Physician Assistant
  • Silver City, NM
National Provider Identifier
1760449698
Registry record updated Apr 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2003-0002 Issued in NM
Practice address
2600 N Silver St
Silver City, NM 88061-7201
Phone
(575) 388-1889
Fax
(575) 388-9952
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2003-0002 NM Primary

Addresses

Primary practice location

2600 N Silver St
Silver City, NM 88061-7201

Mailing address

1618 E Pine St
Silver City, NM 88061-7155
Phone (575) 388-1561

Other practice location 1

1280 E 32nd St
Silver City, NM 88061-7229
Phone (575) 388-1889

Other identifiers 1

IdentifierTypeStateIssuer
69230030MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090923000665 NM Practitioner - Physician Assistant 3870649486 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Utah School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Victor a. Nwachuku, M.D., PCGroup PAC ID 5496833774, 11 clinicians

Practice addresses (Care Compare)

1618 E Pine St
Silver City, NM 88061-7155
Phone 575388156112

Hospital & facility affiliations

  • Gila Regional Medical Center Hospital, Silver City, NM, CCN 321311

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Granger Medical Specialists LLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743638400000",
    "number": "1760449698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1618 E PINE ST",
            "city": "SILVER CITY",
            "state": "NM",
            "postal_code": "880617155",
            "telephone_number": "575-388-1561",
            "fax_number": "575-388-9952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 N SILVER ST",
            "city": "SILVER CITY",
            "state": "NM",
            "postal_code": "880617201",
            "telephone_number": "575-388-1889",
            "fax_number": "575-388-9952"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1280 E 32nd St",
            "address_purpose": "LOCATION",
            "city": "Silver City",
            "state": "NM",
            "postal_code": "880617229",
            "country_code": "US",
            "telephone_number": "575-388-1889",
            "fax_number": "575-388-9952",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REED",
        "first_name": "JOHNNY",
        "middle_name": "W",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2025-04-03",
        "certification_date": "2025-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2003-0002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "69230030",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver City, NM

Sources for this page

Verify at the official NPI Registry.