Individual provider Active NPI

Victorino Fua Reyes Jr., PT/DPT

  • Physical Therapist
  • Louisville, KY
National Provider Identifier
1821039363
Registry record updated Dec 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
003696 Issued in KY
Practice address
210 E Gray St Ste 807
Louisville, KY 40202-3927
Phone
(502) 587-9350
Fax
(502) 587-9351
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05004458A IN
Physical Therapist 225100000X 003696 KY Primary

Addresses

Primary practice location

210 E Gray St Ste 807
Louisville, KY 40202-3927

Mailing address

6614 Doris CT
Sellersburg, IN 47172-9153
Phone (812) 246-1506

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)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
05004458AINMDPhysical Therapist
003696KYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky Orthopedic Rehabilitation, LLC Past Accepting new patients
Kentucky Orthopedic Rehabilitation, LLC Physical Therapist 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.

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259625600000",
    "number": "1821039363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6614 DORIS CT",
            "city": "SELLERSBURG",
            "state": "IN",
            "postal_code": "471729153",
            "telephone_number": "812-246-1506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 E GRAY ST STE 807",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402023927",
            "telephone_number": "502-587-9350",
            "fax_number": "502-587-9351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "VICTORINO",
        "middle_name": "FUA",
        "name_suffix": "Jr.",
        "credential": "PT/DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2009-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05004458A",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "003696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2009; 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.