David Lee Reaves Jr.
Individual provider Active NPI Community Health Worker · Gordon, GA
NPI 1922426360 · NPPES record last updated Apr 2, 2014
Key facts
- NPI
- 1922426360
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Community Health Worker 172V00000X
- Practice address
- 322 Milledgeville Hwy
Gordon, GA 31031-4177 - Phone
- (478) 628-4007
- Fax
- (478) 628-4007
- NPI assigned
- Apr 2, 2014
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | Yes |
Addresses
Primary practice location
322 Milledgeville Hwy
Gordon, GA 31031-4177
Mailing address
P.O Box 703
322 Milledgeville Highway
Gordon, GA 31031
Phone (478) 628-4007
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 332B00000X | Other | GA | N/A |
Other names
- Mr. David Lee Reaves Jr.
Other providers in Gordon, GA
- Living Our Lives (Lol) Community Living LLC
- Lorraine Lynch
- Lisa Marie McIntyre
- Anfernee Powell
- Professional Nursing Services of NA, LTD
- Pamela Reaves
- Reese Family Healthcare, LLC
- Brian O Reese
- Jamia A Reese
- Jerry Reese Jr.
All providers in Gordon, GA · Community Health Worker in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 2, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.