RANDY BENTLEY REED - NPI NUMBER 1588939912

Summary

Provider Name: RANDY BENTLEY REED

NPI Number: 1588939912

Clasification: Chiropractor (111NS0005X)

Specialization: Sports Physician

Address:
34501 AURORA RD
SUITE 100
SOLON, OH
ZIP 44139

Phone Number: (440) 248-2866



Detailed Information

RANDY BENTLEY REED is a sports physician chiropractor in Solon, OH. The provider is a sports chiropractor is uniquely trained to provide care and treatment of injuries or illness resulting from sports and physical fitness activities. Doctors of Chiropractic with the Diplomate American Chiropractic Board of Sports Physicians (DACBSP) or the Certified Chiropractic Sports Physician (CCSP), sport specialty certifications from the American Chiropractic Board of Sports Physicians, have advanced training in the assessment, management and rehabilitation of sports related injuries. Extremity care, rehabilitation and soft tissue procedures are common skills utilized by these doctors. The specialty training covers a broad spectrum from the pediatric athlete to professional and Olympic athletes, and everything in between, using a variety of techniques and modalities. The assigned NPI number for this provider is 1588939912 and is registered as an organization entity type and is a multiple single specialty group.

The provider's business address is:

34501 AURORA RD
SUITE 100
SOLON, OH
ZIP 44139-873
Phone: (440) 248-2866
Fax: (440) 248-0242

The provider's authorized official is Randy B. Reed .
The authorized official title is President and has the following contact phone number (440) 248-2866.

The enumeration date for this NPI number is 3/19/2012 and was last updated on 11/9/2012.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 111NS0005X Chiropractor Sports Physician 1197 OH No
2 111N00000X Chiropractor 1197 OH Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 0583081 MEDICARE UPIN OH
2 0625676 MEDICAID OH

NPI Record

No. Field Name Field Value
1 NPI 1588939912
2 Entity Type Code 2
3 Employer Identification Number EIN
4 Provider Organization Name Legal Business Name RANDY BENTLEY REED
5 Provider First Line Business Practice Location Address 34501 AURORA RD
6 Provider Second Line Business Practice Location Address SUITE 100
7 Provider Business Practice Location Address City Name SOLON
8 Provider Business Practice Location Address State Name OH
9 Provider Business Practice Location Address Postal Code 441393873
10 Provider Business Practice Location Address Country Code If outside U S US
11 Provider Business Practice Location Address Telephone Number 4402482866
12 Provider Business Practice Location Address Fax Number 4402480242
13 Provider Enumeration Date 3/19/2012
14 Last Update Date 11/9/2012
15 Authorized Official Last Name REED
16 Authorized Official First Name RANDY
17 Authorized Official Middle Name B.
18 Authorized Official Title or Position PRESIDENT
19 Authorized Official Telephone Number 4402482866
20 Healthcare Provider Taxonomy Code 1 111NS0005X
21 Provider License Number 1 1197
22 Provider License Number State Code 1 OH
23 Healthcare Provider Primary Taxonomy Switch 1 N
24 Healthcare Provider Taxonomy Code 2 111N00000X
25 Provider License Number 2 1197
26 Provider License Number State Code 2 OH
27 Healthcare Provider Primary Taxonomy Switch 2 Y
28 Other Provider Identifier 1 0583081
29 Other Provider Identifier Type Code 1 02
30 Other Provider Identifier State 1 OH
31 Other Provider Identifier 2 0625676
32 Other Provider Identifier Type Code 2 05
33 Other Provider Identifier State 2 OH
34 Is Organization Subpart N
35 Authorized Official Name Prefix Text DR.
36 Authorized Official Credential Text D.C.
37 Healthcare Provider Taxonomy Group 1 193400000X MULTIPLE SINGLE SPECIALTY GROUP
38 Healthcare Provider Taxonomy Group 2 193400000X MULTIPLE SINGLE SPECIALTY GROUP

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This page was last updated on: 9/11/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.