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

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 Field Definition 1
1 NPI 1588939912 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 2 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Employer Identification Number EIN The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
4 Provider Organization Name Legal Business Name RANDY BENTLEY REED The name of the organization provider. If the provider is an organization, this is the legal business name.
5 Provider First Line Business Practice Location Address 34501 AURORA RD The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
6 Provider Second Line Business Practice Location Address SUITE 100 The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
7 Provider Business Practice Location Address City Name SOLON The city name in the location address of the provider being identified.
8 Provider Business Practice Location Address State Name OH The State code in the location of the provider being identified.
9 Provider Business Practice Location Address Postal Code 441393873 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
10 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
11 Provider Business Practice Location Address Telephone Number 4402482866 The telephone number associated with the location address of the provider being identified.
12 Provider Business Practice Location Address Fax Number 4402480242 The fax number associated with the location address of the provider being identified.
13 Provider Enumeration Date 3/19/2012 The date the provider was assigned a unique identifier (assigned an NPI).
14 Last Update Date 11/9/2012 The date that a record was last updated or changed.
15 Authorized Official Last Name REED The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
16 Authorized Official First Name RANDY The first name of the authorized official.
17 Authorized Official Middle Name B. The middle name of the authorized official.
18 Authorized Official Title or Position PRESIDENT The title or position of the authorized official.
19 Authorized Official Telephone Number 4402482866 The 10-position telephone number of the authorized official.
20 Healthcare Provider Taxonomy Code 1 111NS0005X The 10-position telephone number of the authorized official.
21 Provider License Number 1 1197 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
22 Provider License Number State Code 1 OH The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
23 Healthcare Provider Primary Taxonomy Switch 1 N
24 Healthcare Provider Taxonomy Code 2 111N00000X
25 Provider License Number 2 1197 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
26 Provider License Number State Code 2 OH The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
27 Healthcare Provider Primary Taxonomy Switch 2 Y
28 Other Provider Identifier 1 0583081 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
29 Other Provider Identifier Type Code 1 02 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
30 Other Provider Identifier State 1 OH
31 Other Provider Identifier 2 0625676 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
32 Other Provider Identifier Type Code 2 05 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
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: 4/19/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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