Basic Information
| Provider Information | |||||||||
| NPI: | 1538380993 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | REED | ||||||||
| FirstName: | NATHAN | ||||||||
| MiddleName: | JAMES | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4015 GATEWAY BLVD STE 2120 | ||||||||
| Address2: | |||||||||
| City: | NEWBURGH | ||||||||
| State: | IN | ||||||||
| PostalCode: | 476308925 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8128420907 | ||||||||
| FaxNumber: | 8124644485 | ||||||||
| Practice Location | |||||||||
| Address1: | 4015 GATEWAY BLVD | ||||||||
| Address2: | SUITE 2120 | ||||||||
| City: | NEWBURGH | ||||||||
| State: | IN | ||||||||
| PostalCode: | 476308925 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8128420907 | ||||||||
| FaxNumber: | 8124907054 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/02/2007 | ||||||||
| LastUpdateDate: | 03/04/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/04/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 01066333A | IN | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207R00000X | 01066333A | IN | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0001X | 01066333A | IN | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Clinical Cardiac Electrophysiology |
ID Information
| ID | Type | State | Issuer | Description | P00737656 | 01 | IN | RR MEDICARE | OTHER | 000000621222 | 01 | IN | ANTHEM | OTHER | 200946870 | 05 | IN | MEDICAID | 979995 | 01 | HEALTHLINK | OTHER |