Individual provider Active NPI

John P Reed, M.D.

  • Internal Medicine Physician
  • Maple Grove, MN
National Provider Identifier
1952366338
Registry record updated Jan 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
53740 Issued in MN
Practice address
9555 Upland LN N FL 3
Maple Grove, MN 55369-4485
Phone
(952) 993-1440
Fax
(952) 977-3172
NPI assigned
Apr 19, 2006
Last updated
Jan 15, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 53740 MN Primary
Pediatrics Physician 208000000X 53740 MN

Addresses

Primary practice location

9555 Upland LN N FL 3
Maple Grove, MN 55369-4485

Mailing address

9555 Upland LN N FL 3
Maple Grove, MN 55369-4485
Phone (952) 993-1440

Other identifiers 1

IdentifierTypeStateIssuer
420301100MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20110412001018 MN Practitioner - Pediatric MedicinePractitioner - Internal Medicine 4486795259 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53740MNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic Pediatrics CurrentSince Oct 14, 2013 Accepting new patients
Park Nicollet Clinic Pediatrics CurrentSince Oct 14, 2013 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

9555 Upland Ln N
Fl 3
Maple Grove, MN 55369
Phone (952) 993-1440

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

Interoperability endpoints

  • Direct secure messaging: jreed153334@direct.healthpartners.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579046400000",
    "number": "1952366338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9555 UPLAND LN N FL 3",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694485",
            "telephone_number": "952-993-1440",
            "fax_number": "952-977-3172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9555 UPLAND LN N FL 3",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694485",
            "telephone_number": "952-993-1440",
            "fax_number": "952-977-3172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REED",
        "first_name": "JOHN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "53740",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "53740",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420301100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

Verify at the official NPI Registry.