Active NPI
Andrew Douglas Reisner, PSY. D.
- Clinical Psychologist
- Cambridge, OH
National Provider Identifier
1871692772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 4109
- Practice address
- 66737 Old Twenty One Rd
Cambridge, OH 43725-8987 - Phone
- (740) 439-1371
- Fax
- (740) 432-1954
- NPI assigned
- Sep 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 4109 | OH | Primary |
Addresses
Primary practice location
66737 Old Twenty One Rd
Cambridge, OH 43725-8987
Mailing address
66737 Old Twenty One Rd
Cambridge, OH 43725-8987
Phone (740) 439-1371
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1871692772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "66737 OLD TWENTY ONE RD",
"city": "CAMBRIDGE",
"state": "OH",
"postal_code": "437258987",
"telephone_number": "740-439-1371",
"fax_number": "740-432-1954"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "66737 OLD TWENTY ONE RD",
"city": "CAMBRIDGE",
"state": "OH",
"postal_code": "437258987",
"telephone_number": "740-439-1371",
"fax_number": "740-432-1954"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REISNER",
"first_name": "ANDREW",
"middle_name": "DOUGLAS",
"credential": "PSY. D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OH",
"license": "4109",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cambridge, OH
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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.