Individual provider Active NPI

Ryan Robert Reeves, PHARMD

  • Pharmacist
  • Kendallville, IN
National Provider Identifier
1962044974
Registry record updated Oct 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
26023800A Issued in IN
Practice address
1930 Dowling St Ste P
Kendallville, IN 46755-9436
Phone
(260) 582-2151
Fax
(260) 544-3369
NPI assigned
Oct 10, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 26023800A IN Primary

Addresses

Primary practice location

1930 Dowling St Ste P
Kendallville, IN 46755-9436

Mailing address

1930 Dowling St Ste P
Kendallville, IN 46755-9436
Phone (260) 582-2151

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
26023800AINMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Genoa Healthcare LLC CurrentSince Jun 18, 2023 Accepting new patients
Genoa Healthcare LLC PastSince Oct 13, 2019 Accepting new patients

Locations

1930 Dowling St
Ste P
Kendallville, IN 46755
Phone (260) 582-2151

Organizations & group practices 2

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": "1570665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570665600000",
    "number": "1962044974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 DOWLING ST STE P",
            "city": "KENDALLVILLE",
            "state": "IN",
            "postal_code": "467559436",
            "telephone_number": "260-582-2151",
            "fax_number": "260-544-3369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 DOWLING ST STE P",
            "city": "KENDALLVILLE",
            "state": "IN",
            "postal_code": "467559436",
            "telephone_number": "260-582-2151",
            "fax_number": "260-544-3369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REEVES",
        "first_name": "RYAN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-10",
        "last_updated": "2019-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26023800A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kendallville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.