Blake Reed, D.C.

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

License

038013743 Issued in IL

Practice address

2013 Johnson Rd Ste D
Granite City, IL 62040-3980

Phone

(618) 931-2050

Fax

(618) 931-2048

NPI assigned

Jul 23, 2021

Last updated

Jul 23, 2021By 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

Enrolled in IL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Complete Spine and Performance LLC

  • Clinic/Center
  • Collinsville, IL
  • NPI 1417732009
  Medicare reassignment NPD Authorized official
• Regenerative Health and Chiropractic, LTD

  • Physical Medicine & Rehabilitation Physician
  • Granite City, IL
  • NPI 1205571262
  Medicare reassignment NPD

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

{
    "created_epoch": "1626998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626998400000",
    "number": "1770156937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2013 JOHNSON RD STE D",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620403980",
            "telephone_number": "618-931-2050",
            "fax_number": "618-931-2048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2013 JOHNSON RD STE D",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620403980",
            "telephone_number": "618-931-2050",
            "fax_number": "618-931-2048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REED",
        "first_name": "BLAKE",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-23",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "IL",
            "license": "038013743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ray Medical Supply LLC
• Bridget Ray, FNP-C
• Debabrata Ray, MD
• Jessica Dawn Ray, D.C
• Kasey Jo Reader
• Ruth Reeves
• Regeneration Orthopedics, LLC
• Regenerative Health and Chiropractic, LTD
• Renal Treatment Centers-Illinois Inc (Granite City Dialysis Center)
• Residential Options

• Rehabilitation Chiropractor in Granite City, IL
• Providers in Granite City, IL by specialty
• Rehabilitation Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.