Individual provider Active NPI

Ethel Mae Reese, RN

  • Registered Nurse
  • Big Stone Gap, VA
National Provider Identifier
1922351659
Registry record updated Oct 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
0001124033 Issued in VA
Practice address
1508 3Rd Ave East
Big Stone Gap, VA 24219
Phone
(276) 523-0599
Fax
(276) 523-6492
NPI assigned
Oct 18, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 0001124033 VA Primary

Addresses

Primary practice location

1508 3Rd Ave East
Big Stone Gap, VA 24219

Mailing address

1508 3Rd Ave East
PO Box 888
Big Stone Gap, VA 24219
Phone (276) 523-0599

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
0001124033VAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Empire Older Citzens Pace Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1350518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350518400000",
    "number": "1922351659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1508 3RD AVE EAST",
            "address_2": "PO BOX 888",
            "city": "BIG STONE GAP",
            "state": "VA",
            "postal_code": "24219",
            "telephone_number": "276-523-0599",
            "fax_number": "276-523-6492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1508 3RD AVE EAST",
            "city": "BIG STONE GAP",
            "state": "VA",
            "postal_code": "24219",
            "telephone_number": "276-523-0599",
            "fax_number": "276-523-6492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REESE",
        "first_name": "ETHEL",
        "middle_name": "MAE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-18",
        "last_updated": "2012-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001124033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Big Stone Gap, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2012; 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.