Individual provider Active NPI

Jeffrey William Rinehart, LPA

  • Clinical Psychologist
  • Clemmons, NC
National Provider Identifier
1982623914
Registry record updated May 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2387 Issued in NC
Practice address
2235 Lewisville Clemmons Rd Ste a
Clemmons, NC 27012-9342
Phone
(336) 722-7266
Fax
(336) 201-0538
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2387 NC Primary

Addresses

Primary practice location

2235 Lewisville Clemmons Rd Ste a
Clemmons, NC 27012-9342

Mailing address

713 S Marshall St Ste 100
Winston Salem, NC 27101-5808
Phone (336) 722-7266

Other identifiers 2

IdentifierTypeStateIssuer
6107177MedicaidNC
046APOtherNCBLUE CROSS BLUE SHIELD

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mood Treatment Center, PLLC CurrentSince May 7, 2023 Accepting new patients
Complete Care Partners LLC PastSince May 7, 2023 Accepting new patients

Locations

2235 Lewisville Clemmons Rd
Ste A
Clemmons, NC 27012
Phone (336) 408-6917

713 S Marshall St
Ste 100
Winston Salem, NC 27101

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1982623914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 S MARSHALL ST STE 100",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271015808",
            "telephone_number": "336-722-7266",
            "fax_number": "336-201-0538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2235 LEWISVILLE CLEMMONS RD STE A",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270129342",
            "telephone_number": "336-722-7266",
            "fax_number": "336-201-0538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RINEHART",
        "first_name": "JEFFREY",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "LPA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "2387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6107177",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "046AP",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clemmons, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2023; 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.