Active NPI
Donald Eugene Reeder Jr., PA-C
- Medical Physician Assistant
- Lake Havasu City, AZ
National Provider Identifier
1942472329
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 3220
- Practice address
- 1810 Mesquite Ave
Suite B
Lake Havasu City, AZ 86403-5886 - Phone
- (928) 453-4600
- NPI assigned
- Mar 26, 2008
- Last updated
- Sep 22, 2010
- 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 3220 | AZ | Primary |
Addresses
Primary practice location
1810 Mesquite Ave
Suite B
Lake Havasu City, AZ 86403-5886
Mailing address
1810 Mesquite Ave
Suite B
Lake Havasu City, AZ 86403-5886
Phone (928) 453-4600
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3220 | AZ | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285113600000",
"number": "1942472329",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1810 MESQUITE AVE",
"address_2": "SUITE B",
"city": "LAKE HAVASU CITY",
"state": "AZ",
"postal_code": "864035886",
"telephone_number": "928-453-4600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1810 MESQUITE AVE",
"address_2": "SUITE B",
"city": "LAKE HAVASU CITY",
"state": "AZ",
"postal_code": "864035886",
"telephone_number": "928-453-4600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REEDER",
"first_name": "DONALD",
"middle_name": "EUGENE",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-03-26",
"last_updated": "2010-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "AZ",
"license": "3220",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Havasu City, AZ
- Maria Rawson, LAC
- Susan Lynn Read, MS SLP
- Pamela B. Reband, M.D.
- Patricia K Reddicks, R.D
- Scott C. Redman, OCCUPATIONAL THERAPY
- Reflex Reading, LLC
- Stanton N Rehkemper, PT, DPT
- Franciane Fonseca Goncalves Reis, ND
- Renal Care Group Arizona, LLC (Renal Care Group - Lake Havasu)
- Rheumatology & Arthritis Consultants, PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.