Individual provider Active NPI

Sean Alan Reese, D.C.

  • Sports Physician Chiropractor
  • Wilmington, NC
National Provider Identifier
1821035692
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
2068 Issued in NC
Practice address
2210 Wrightsville Ave
Suite 3C
Wilmington, NC 28403-2406
Phone
(910) 392-3100
NPI assigned
Jun 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X 2068 NC Primary

Addresses

Primary practice location

2210 Wrightsville Ave
Suite 3C
Wilmington, NC 28403-2406

Mailing address

1118 Country Club Rd
Wilmington, NC 28403-2517
Phone (910) 343-2900

Other identifiers 1

IdentifierTypeStateIssuer
890876NMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060928000356 NC Practitioner - Chiropractic 9133124951 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beasley IncGroup PAC ID 6305841123, 2 clinicians

Practice addresses (Care Compare)

2210 Wrightsville Ave
Suite 3C
Wilmington, NC 28403-2575
Phone (910) 392-3100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2068NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Beasley, Inc. Sports Physician CurrentSince Feb 19, 2001 Accepting new patients
Blue Ridge Health and Spine, PLLC PastSince Sep 3, 2016 Accepting new patients

Locations

2210 Wrightsville Ave
Ste 3C
Wilmington, NC 28403
Phone (910) 392-3100

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.

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821035692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1118 COUNTRY CLUB RD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284032517",
            "telephone_number": "910-343-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 WRIGHTSVILLE AVE",
            "address_2": "SUITE 3C",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284032406",
            "telephone_number": "910-392-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REESE",
        "first_name": "SEAN",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "NC",
            "license": "2068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890876N",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.