DR. WALTER SCOTT REID (NPI# 1932180387) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932180387 |
| Entity Type | Individual |
| Full Name | DR. WALTER SCOTT REID |
| Credential | DO |
| Practice Address |
900 Main St Suite 530 Peoria IL 61602-1005 |
| Practice Telephone | 3096725975 |
| Practice Fax Number | 3096551678 |
| Mailing Telephone | 3096725975 |
| Mailing Fax Number | 3096551678 |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2020-08-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 036095933 | IL | Allopathic & Osteopathic Physicians |
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
036095933 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036095933 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720182017 | Walter W Reid IIi | Dentist | 570 W Lanier Ave, Bldg #2, Fayetteville, GA 30214-7649 | 2006-09-08 |
| 1275734089 | Walter James Reid Jr. | Occupational Therapy Assistant | 4444 W Meadow Ave, Visalia, CA 93277-1652 | 2007-05-30 |
| Street Address |
900 MAIN ST SUITE 530 |
| City | PEORIA |
| State | IL |
| Zip Code | 61602-1005 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295260784 | Alexandra Gens | Psychiatry & Neurology | 900 Main St, Suite 720, Peoria, IL 61602-1005 | 2017-04-22 |
| 1407380751 | Unitypoint Health Methodist | Psychiatry & Neurology | 900 Main St, Suite 720, Peoria, IL 61602-1005 | 2017-04-13 |
| 1669823068 | Kory Jackson | Nurse Practitioner | 900 Main St, Ste 100, Peoria, IL 61602-1005 | 2016-06-27 |
| 1932554714 | Jamie Schupbach | Nurse Practitioner | 900 Main St, Ste 600, Peoria, IL 61602-1005 | 2016-04-28 |
| 1407223969 | Teresa Michelle Watts | Nurse Practitioner | 900 Main St, Suite 100, Peoria, IL 61602-1005 | 2015-08-31 |
| 1487054433 | Christina Lowrance | Nurse Practitioner | 900 Main St, Peoria, IL 61602-1005 | 2014-08-27 |
| 1295158194 | Karolina Wozny | Physician Assistant | 900 Main St, Suite 630, Peoria, IL 61602-1005 | 2014-01-28 |
| 1821423583 | Radha K Chathadi | Registered Nurse | 900 Main St, Suite 630, Peoria, IL 61602-1005 | 2013-09-12 |
| 1558796789 | Erin Surratt | Social Worker | 900 Main St, Suite 400, Peoria, IL 61602-1005 | 2013-09-06 |
| 1336490333 | Susan Copp | Nurse Practitioner | 900 Main St, Suite 600, Peoria, IL 61602-1005 | 2012-10-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720574676 | Critical Care Rx, LLC | Pharmacy | 126 Oak St, Peoria, IL 61602 | 2018-07-03 |
| 1235675836 | Cheryl Beckman | Registered Nurse | 211 Fulton Street, Suite 207, One Technology Plaza, Peoria, IL 61602 | 2017-01-06 |
| 1063957942 | Rosemary Ince | Registered Nurse | 211 Fulton St. Suite 207, One Technology Plaza, Peoria, IL 61602 | 2016-12-30 |
| 1962674820 | Lisa Jean Burckhartzmeyer | Psychiatry & Neurology | 228 Ne Jefferson St, Peoria, IL 61602 | 2008-03-31 |
| 1669503587 | Jill Larson | Counselor | 330 Sw Washington Street, Peoria, IL 61602 | 2007-03-09 |
| 1265407399 | Cardiac Consultants Sc | Internal Medicine | 900 Main Street, Suite 320, Peoria, IL 61602 | 2006-02-22 |
| 1013364470 | Rafal Szymczuk | Student in an Organized Health Care Education/Training Program | 900 Main Street, Suite 720, Peoria, IL 61602 | 2016-05-16 |
| 1043693831 | Kari Beth Watts | Family Medicine | 815 Main St, Peoria, IL 61602 | 2015-06-30 |
| 1881072791 | Kristen Dent | Family Medicine | 815 Main St, Peoria, IL 61602 | 2015-05-12 |
| 1023422797 | Andrew Wang | Psychiatry & Neurology | 900 Main St Ste 580, Peoria, IL 61602 | 2014-06-20 |
| Find all providers in zip 61602 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790049617 | Sonoran Vein and Endovascular LLC | Surgery | 9200 W Union Hills Dr, Ste A-103, Peoria, AZ 85382-8210 | 2012-06-25 |
| 1306043211 | Sean Benedict D'souza | Surgery | 9192 W Union Hills Dr, Peoria, AZ 85382-8208 | 2007-07-03 |
| 1912970617 | Dale M Geiss | Surgery | 515 Ne Glen Oak, Suite 105, Peoria, IL 61603-3167 | 2006-02-12 |
| 1265433882 | James Bertram Williams | Surgery | 2420 W Nebraska Ave, Peoria, IL 61604-3112 | 2005-08-04 |
| 1487281770 | Titan Medical Services, LLC | Surgery | 13660 N 94th Dr # D-1, Peoria, AZ 85381-4836 | 2020-03-25 |
| 1164700183 | Jessica L Secor | Surgery | 7725 N Knoxville Ave, Peoria, IL 61614-2079 | 2011-07-25 |
| 1982929121 | Sammy Zakhary Md PC | Surgery | 15396 N 83rd Ave, Suite E, Peoria, AZ 85381-5622 | 2010-03-31 |
| 1699783886 | James R Debord | Surgery | 5409 N Knoxville Ave, Peoria, IL 61614-5016 | 2006-08-03 |
| 1962417485 | Cardiac Thoracic & Endovascular Therapies, S.c. | Surgery | 2420 W Nebraska Ave, Peoria, IL 61604-3112 | 2006-07-31 |
| 1063454197 | Andy C. Chiou | Surgery | 1001 Main Street, 3rd Floor, Peoria, IL 61606-2037 | 2006-06-12 |
| Find all providers in PEORIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.