Active NPI
Victorino Fua Reyes Jr., PT/DPT
- Physical Therapist
- Louisville, KY
National Provider Identifier
1821039363
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 003696
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05004458A | IN | MD | Physical Therapist |
| 003696 | KY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Physical Therapy Clinic/Center
- Richmond, KY
- NPI 1295477248
-
- Physical Therapy Clinic/Center
- Lexington, KY
- NPI 1730189762
Physical Therapist
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.