Individual provider Active NPI

Gregg Tyler Reese, DC

  • Chiropractor
  • Hollywood, FL
National Provider Identifier
1992787162
Registry record updated Dec 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH0007234 Issued in FL
Practice address
3260 Stirling Rd
Hollywood, FL 33021-2041
Phone
(954) 989-4738
Fax
(954) 989-7600
NPI assigned
Nov 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH0007234 FL Primary

Addresses

Primary practice location

3260 Stirling Rd
Hollywood, FL 33021-2041

Mailing address

3260 Stirling Rd
Hollywood, FL 33021-2041
Phone (954) 989-4738

Other identifiers 2

IdentifierTypeStateIssuer
381077100MedicaidFL
CH0007234OtherFLLISCENCE #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110421000880 FL Practitioner - Chiropractic 1951585678 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3260 Stirling Rd
Hollywood, FL 33021-2041

3260 Stirling Rd a
Hollywood, FL 33021-2041
Phone (954) 989-4738

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH0007234FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Gregg T Reese DC PA Chiropractor CurrentSince Feb 6, 2011 Accepting new patients

Locations

3260 Stirling Rd
Hollywood, FL 33021
Phone (954) 989-4738

3260 Stirling Rd
Ste A
Hollywood, FL 33021
Phone (954) 989-4738

Networks

  • Freedom Health HMO Network

Organizations & group practices 1

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": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291161600000",
    "number": "1992787162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3260 STIRLING RD",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330212041",
            "telephone_number": "954-989-4738",
            "fax_number": "954-989-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3260 STIRLING RD",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330212041",
            "telephone_number": "954-989-4738",
            "fax_number": "954-989-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REESE",
        "first_name": "GREGG",
        "middle_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2010-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0007234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "381077100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LISCENCE #",
            "identifier": "CH0007234",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.