NPIMap

Individual provider Active NPI

Jeremy L Reed, PA-C

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1902420540
Registry record updated May 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
6406 W Buckskin TRL
Phoenix, AZ 85083-3445
Phone
(623) 341-5728
NPI assigned
May 29, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

6406 W Buckskin TRL
Phoenix, AZ 85083-3445

Mailing address

6406 W Buckskin TRL
Phoenix, AZ 85083-3445
Phone (623) 341-5728

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200901001589 AZ Practitioner - Physician Assistant 0840617106 Reassigns benefits to 7 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
7965AZMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Acute Medical Services 1 PC Past Accepting new patients
Exceptional Health Care Prescott LLC PastSince Aug 1, 2024 Accepting new patients
Exceptional Health Care Bullhead City LLC PastSince Nov 19, 2023 Accepting new patients

Organizations & group practices 10

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": "1590710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590710400000",
    "number": "1902420540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6406 W BUCKSKIN TRL",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850833445",
            "telephone_number": "623-341-5728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6406 W BUCKSKIN TRL",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850833445",
            "telephone_number": "623-341-5728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REED",
        "first_name": "JEREMY",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-29",
        "last_updated": "2020-05-29",
        "certification_date": "2020-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.