Matthew Reyes

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

403 E Chester St
Norfolk, VA 23503-3707

Phone

(757) 401-8184

NPI assigned

May 31, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1622419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622419200000",
    "number": "1891361986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 E CHESTER ST",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235033707",
            "telephone_number": "757-401-8184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 E CHESTER ST",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235033707",
            "telephone_number": "757-401-8184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-31",
        "last_updated": "2021-05-31",
        "certification_date": "2021-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "mreye003@odu.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "403 E Chester St",
            "city": "Norfolk",
            "state": "VA",
            "country_code": "US",
            "postal_code": "235033707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Revitalize Function LLC
• Rewired Canvas Psychotherapy LLC
• Amber Lynn Reyes, PA
• James Reyes
• Janet A Reyes
• Jillian Reynolds, DDS
• Madeline Reynolds, MSW, LCSW
• Shaun M Reynolds, M.D.
• Joseph A Reza, MD
• Syed Mobeen Reza, D.O.

• Student in an Organized Health Care Education/Training Program in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Student in an Organized Health Care Education/Training Program in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2021; 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.