Active NPI
Shannon Richard Reed, PEDORTHIST
- Specialist
- Sacramento, CA
National Provider Identifier
1962724575
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- CPED3329
- Practice address
- 719 56TH St
Sacramento, CA 95819-3306 - Phone
- (916) 457-2726
- Fax
- (916) 457-2728
- NPI assigned
- Feb 23, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | CPED3329 | CA | Primary |
Addresses
Primary practice location
719 56TH St
Sacramento, CA 95819-3306
Mailing address
719 56TH St
Sacramento, CA 95819-3306
Phone (916) 457-2726
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CPED3329 | CA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274400000000",
"number": "1962724575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "719 56TH ST",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958193306",
"telephone_number": "916-457-2726",
"fax_number": "916-457-2728"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "719 56TH ST",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958193306",
"telephone_number": "916-457-2726",
"fax_number": "916-457-2728"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REED",
"first_name": "SHANNON",
"middle_name": "RICHARD",
"name_prefix": "Mr.",
"credential": "PEDORTHIST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-02-23",
"last_updated": "2010-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CA",
"license": "CPED3329",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.