Provider Demographics
NPI:1861472201
Name:REINHARDT, JEFF CHARLES (MD)
Entity Type:Individual
Prefix:
First Name:JEFF
Middle Name:CHARLES
Last Name:REINHARDT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5221 PARAMOUNT PKWY STE 420
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-5491
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 MANNING DR
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-4220
Practice Address - Country:US
Practice Address - Phone:919-843-9247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01079057A207V00000X
GA047250207V00000X
NC2021-02952207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000834974BMedicaid
GA000834974EMedicaid
GA000834974FMedicaid
GA5277291OtherCIGNA
GA7702048OtherAETNA
GA160054842OtherRR MEDICARE-GRP # CC4177
IN300005973Medicaid
GA000834974DMedicaid
GA52702265OtherBCBS
GA0732484OtherUHC
GA329038OtherWELLCARE
GA10045212OtherAMERIGROUP
GA160054842OtherRR MEDICARE-GRP # CC4177
GA000834974FMedicaid