Individual provider Active NPI

Betti D Reese, MD

  • Family Medicine Physician
  • Greensboro, NC
National Provider Identifier
1922063114
Registry record updated Dec 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
200100186 Issued in NC
Practice address
5500 W Friendly Ave
Suite 201
Greensboro, NC 27410-4212
Phone
(336) 856-9996
Fax
(336) 856-9976
NPI assigned
Apr 19, 2006
Last updated
Dec 5, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 200100186 NC Primary

Addresses

Primary practice location

5500 W Friendly Ave
Suite 201
Greensboro, NC 27410-4212

Mailing address

5500 W Friendly Ave
Suite 201
Greensboro, NC 27410-4212
Phone (336) 856-9996

Other identifiers 1

IdentifierTypeStateIssuer
89128G7MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041018001227 NC Practitioner - Family Practice 6507826013 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wright State University Boonshoft School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2515 Oakcrest Ave
Greensboro, NC 27408-4707

2515 Oakcrest Ave
Greensboro, NC 27408-4724
Phone 3368569996336

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
200100186NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Immanuel Family Practice CurrentSince Aug 20, 2004 Accepting new patients
Bland Clinic, PA Family Medicine PastSince Oct 1, 2000 Accepting new patients

Locations

2515 Oakcrest Ave
Greensboro, NC 27408
Phone (336) 545-5211

5500 W Friendly Ave
Ste 201
Greensboro, NC 27410
Phone (336) 856-9996

Interoperability endpoints

  • Direct secure messaging: immanuelfamilypractice.bettireese@142402.advancedmd-direct.com

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, 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": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196812800000",
    "number": "1922063114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 W FRIENDLY AVE",
            "address_2": "SUITE 201",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274104212",
            "telephone_number": "336-856-9996",
            "fax_number": "336-856-9976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 W FRIENDLY AVE",
            "address_2": "SUITE 201",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274104212",
            "telephone_number": "336-856-9996",
            "fax_number": "336-856-9976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REESE",
        "first_name": "BETTI",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-19",
        "last_updated": "2007-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "200100186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89128G7",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.