Marilou Reyes, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

28997 Issued in AZ

Practice address

2585 Miracle Mile
Suite 126
Bullhead City, AZ 86442-7522

Phone

(928) 763-7020

Fax

(928) 763-7050

NPI assigned

Sep 9, 2005

Last updated

Jan 6, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Aims Physicians and Surgeons

  • Family Medicine Physician
  • Kingman, AZ
  • NPI 1073699112

  Pediatrics

  NPD (past)
• Arizona Institute of Medicine and Surgery

  • Urgent Care Clinic/Center
  • Kingman, AZ
  • NPI 1881680122
  NPD (past)

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

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388966400000",
    "number": "1972597441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23245",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864393245",
            "telephone_number": "928-763-7020",
            "fax_number": "928-763-7050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2585 MIRACLE MILE",
            "address_2": "SUITE 126",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864427522",
            "telephone_number": "928-763-7020",
            "fax_number": "928-763-7050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "MARILOU",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-09",
        "last_updated": "2014-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "28997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maranda Grace Sorensen Renouard, PHARMD
• Rescare Arizona, Inc.
• Resilient Minds Psychiatry PLLC
• Resilient Minds Psychiatry PLLC
• Sandra Reyes-Mendoza, FNP-C
• Claudette Rhoades, FNP
• Deana Marie Rhoads, FNP-BC
• Richard Bailey, M.D., L.L.C
• James A. Richardson, O.D.
• Russell Rima, RUSSELL RIMA D.D.S.

• Pediatrics Physician in Bullhead City, AZ
• Providers in Bullhead City, AZ by specialty
• Pediatrics Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2014; 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.