Individual provider Active NPI

Renee E Reeder, OD

  • Optometrist
  • Pikeville, KY
National Provider Identifier
1871586289
Registry record updated Jul 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2135DT Issued in KY
Practice address
147 Sycamore St
Pikeville, KY 41501-9118
Phone
(606) 218-5540
Fax
(606) 218-5541
NPI assigned
Aug 31, 2005
Last updated
Jul 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046009035 IL
Optometrist 152W00000X 2135DT KY Primary

Addresses

Primary practice location

147 Sycamore St
Pikeville, KY 41501-9118

Mailing address

147 Sycamore St
Pikeville, KY 41501-9118
Phone (606) 218-5540

Other practice location 1

3241 S Michigan Ave
Chicago, IL 60616-3849
Phone (312) 225-6200

Other identifiers 1

IdentifierTypeStateIssuer
046009035MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190510002170 KY Practitioner - Optometry 6608905435 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of PikevilleGroup PAC ID 6709120942, 18 clinicians

Practice addresses (Care Compare)

147 Sycamore St
Pikeville, KY 41501-9118
Phone (606) 218-5528

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046009035ILMDOptometrist
2135DTKYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Pikeville Optometrist CurrentSince Mar 17, 2019 Accepting new patients

Locations

41 Triangle St
Martin, KY 41649
Phone (606) 218-5540

147 Sycamore St
Pikeville, KY 41501
Phone (606) 218-5250

147 Sycamore St
#858
Pikeville, KY 41501

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594339200000",
    "number": "1871586289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 SYCAMORE ST",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415019118",
            "telephone_number": "606-218-5540",
            "fax_number": "606-218-5541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 SYCAMORE ST",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415019118",
            "telephone_number": "606-218-5540",
            "fax_number": "606-218-5541"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3241 S Michigan Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606163849",
            "country_code": "US",
            "telephone_number": "312-225-6200",
            "fax_number": "312-949-7660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REEDER",
        "first_name": "RENEE",
        "middle_name": "E",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-31",
        "last_updated": "2020-07-10",
        "certification_date": "2020-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009035",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "2135DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046009035",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pikeville, KY

Sources for this page

Verify at the official NPI Registry.