Jose Guadalupe Reyes, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

5502005618 Issued in MI

Practice address

38221 Plymouth Rd Ste 3
Livonia, MI 48150-1051

Phone

(734) 221-0236

Fax

(734) 293-4240

NPI assigned

Dec 21, 2022

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• JBNP Services, LLC

  • Adult Health Nurse Practitioner
  • Livonia, MI
  • NPI 1023637766
  NPD
• JBNP Services, LLC

  • Home Health Agency
  • Livonia, MI
  • NPI 1447038740
  NPD

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

{
    "created_epoch": "1671580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1922710870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38221 PLYMOUTH RD STE 3",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481501051",
            "telephone_number": "734-221-0236",
            "fax_number": "734-293-4240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38221 PLYMOUTH RD STE 3",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481501051",
            "telephone_number": "734-221-0236",
            "fax_number": "734-293-4240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "JOSE",
        "middle_name": "GUADALUPE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-21",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MI",
            "license": "5502005618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cere Louise Rettig
• Melissa Anne Rettmann, PA-C
• Revive Dental Livonia
• Mara Rey Leyes
• Stephanie Marie Reyburn
• Hunter Reynolds
• Rebekah Reynolds, LPC
• Sophie Reznick
• Rheumone Clinic PLLC
• Jayla Sanaa Rhodes

• Physical Therapy Assistant in Livonia, MI
• Providers in Livonia, MI by specialty
• Physical Therapy Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2022; 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.