Active NPI
Robert Bradley Reeves, MD
- Orthopaedic Surgery Physician
- Fayetteville, AR
National Provider Identifier
1790706505
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- C-7011
- Practice address
- 201 W Van Asche Loop
Fayetteville, AR 72703-4996 - Phone
- (479) 966-4491
- NPI assigned
- Jul 21, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 7623 | SD | |
| Orthopaedic Surgery Physician | 207X00000X | 100174 | MO | |
| Orthopaedic Surgery Physician | 207X00000X | C-7011 | AR | Primary |
Addresses
Primary practice location
201 W Van Asche Loop
Fayetteville, AR 72703-4996
Mailing address
PO Box 5074
Sioux Falls, SD 57117-5074
Other practice location 1
1210 W 18th St
Ste G01
Sioux Falls, SD 57104-4647
Phone (605) 328-2663
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11464 | Other | MO | ANTHEM |
| 200033678 | Other | RR MEDICARE | |
| 203311006 | Medicaid | MO | |
| 100135410B | Medicaid | KS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C-7011 | AR | MD | Orthopaedic Surgery Physician |
| 100174 | MO | MD | Orthopaedic Surgery Physician |
| 7623 | SD | MD | Orthopaedic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614038400000",
"number": "1790706505",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5074",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571175074"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 W VAN ASCHE LOOP",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727034996",
"telephone_number": "479-966-4491"
}
],
"practiceLocations": [
{
"address_1": "1210 W 18th St",
"address_2": "Ste G01",
"address_purpose": "LOCATION",
"city": "Sioux Falls",
"state": "SD",
"postal_code": "571044647",
"country_code": "US",
"telephone_number": "605-328-2663",
"fax_number": "605-328-3760",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "REEVES",
"first_name": "ROBERT",
"middle_name": "BRADLEY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-21",
"last_updated": "2021-02-23",
"certification_date": "2021-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "SD",
"license": "7623",
"primary": false
},
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "MO",
"license": "100174",
"primary": false
},
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "AR",
"license": "C-7011",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "11464",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "200033678",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "203311006",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100135410B",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.