Active NPI
Robert Reyes
- Speech-Language Pathologist
- Eaton, OH
National Provider Identifier
1932821238
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 22030886
- Practice address
- 506B Aukerman St
Eaton, OH 45320-1919 - Phone
- (937) 456-3874
- NPI assigned
- Sep 13, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 22030886 | OH | Primary |
Addresses
Primary practice location
506B Aukerman St
Eaton, OH 45320-1919
Mailing address
11 Bellview CT
Tipp City, OH 45371-1401
Phone (859) 916-0589
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 14159030 | Other | ASHA | |
| 22030886 | Other | OH | 5 YEAR PUPIL SERVICES SPEECH LANGUAGE PATHOLOGIST REGISTRATION |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22030886 | OH | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663027200000",
"number": "1932821238",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 BELLVIEW CT",
"city": "TIPP CITY",
"state": "OH",
"postal_code": "453711401",
"telephone_number": "859-916-0589"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "506B AUKERMAN ST",
"city": "EATON",
"state": "OH",
"postal_code": "453201919",
"telephone_number": "937-456-3874"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYES",
"first_name": "ROBERT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-09-13",
"last_updated": "2022-09-13",
"certification_date": "2022-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OH",
"license": "22030886",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ASHA",
"identifier": "14159030",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "5 YEAR PUPIL SERVICES SPEECH LANGUAGE PATHOLOGIST REGISTRATION",
"identifier": "22030886",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Eaton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.