Active NPI
Richard M Reisman, MD
- Pain Medicine (Anesthesiology) Physician
- Grayson, GA
National Provider Identifier
1952344152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine (Anesthesiology) Physician
- License
- 029937
- Practice address
- 2050 Bennett Rd
Grayson, GA 30017-1253 - Phone
- (770) 241-5075
- NPI assigned
- Jun 14, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | 029937 | GA | Primary |
| General Practice Physician | 208D00000X | 150988-1 | NY | |
| General Practice Physician | 208D00000X | 029937 | GA |
Addresses
Primary practice location
2050 Bennett Rd
Grayson, GA 30017-1253
Mailing address
2050 Bennett Rd
Grayson, GA 30017-1253
Phone (770) 241-5075
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00351557A | Medicaid | GA | |
| 000351557A | Medicaid | GA |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 150988-1 | NY | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gwinnett Anesthesia Service PC | 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.
-
- Anesthesiology Physician
- Lawrenceville, GA
- NPI 1528015930
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491782400000",
"number": "1952344152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2050 BENNETT RD",
"city": "GRAYSON",
"state": "GA",
"postal_code": "300171253",
"telephone_number": "770-241-5075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2050 BENNETT RD",
"city": "GRAYSON",
"state": "GA",
"postal_code": "300171253",
"telephone_number": "770-241-5075"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REISMAN",
"first_name": "RICHARD",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-14",
"last_updated": "2017-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "207LP2900X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pain Medicine",
"state": "GA",
"license": "029937",
"primary": true
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "NY",
"license": "150988-1",
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "GA",
"license": "029937",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00351557A",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000351557A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grayson, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.