Provider Demographics
NPI:1164455572
Name:REIN, JODY A (DO)
Entity Type:Individual
Prefix:
First Name:JODY
Middle Name:A
Last Name:REIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12020 COLORADO BLVD
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80241-3562
Mailing Address - Country:US
Mailing Address - Phone:303-255-6940
Mailing Address - Fax:
Practice Address - Street 1:12020 COLORADO BLVD
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80241-3562
Practice Address - Country:US
Practice Address - Phone:303-255-6940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO38418207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO636884OtherBCBS
CO110199472OtherRAILROAD MEDICARE
CO44839022Medicaid
COG63297Medicare UPIN
CO44839022Medicaid