Individual provider Active NPI

Michael Leo Reeves, MD

  • Specialist
  • Chattanooga, TN
National Provider Identifier
1952359093
Registry record updated Jun 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD0000019635 Issued in TN
Practice address
725 Glenwood Dr
Suite E688
Chattanooga, TN 37404-1163
Phone
(423) 648-1148
Fax
(423) 643-2217
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD0000019635 TN Primary

Addresses

Primary practice location

725 Glenwood Dr
Suite E688
Chattanooga, TN 37404-1163

Mailing address

PO Box 80458
Chattanooga, TN 37414-7458
Phone (423) 495-7580

Other identifiers 4

IdentifierTypeStateIssuer
010025756OtherTNRAIL ROAD MEDICARE
0089721OtherTNBLUE CROSS/BLUE SHIELD
TN0101OtherTNJOHN DEERE
621387786OtherTNPRIVATE PAYER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101117001147 TN Practitioner - Endocrinology 6800081787 Practice locations: Chattanooga, TN

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD0000019635TNMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Dianne C. Roland, MD 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.

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277769600000",
    "number": "1952359093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80458",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374147458",
            "telephone_number": "423-495-7580",
            "fax_number": "423-495-7589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 GLENWOOD DR",
            "address_2": "SUITE E688",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041163",
            "telephone_number": "423-648-1148",
            "fax_number": "423-643-2217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REEVES",
        "first_name": "MICHAEL",
        "middle_name": "LEO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2010-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TN",
            "license": "MD0000019635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "010025756",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "0089721",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "TN0101",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE PAYER",
            "identifier": "621387786",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.