Provider Demographics
NPI:1205932910
Name:REED, JOHN CHARLES (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CHARLES
Last Name:REED
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 1:319 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-4125
Mailing Address - Country:US
Mailing Address - Phone:703-598-3164
Mailing Address - Fax:
Practice Address - Street 1:2944 HUNTER MILL RD STE 101
Practice Address - Street 2:
Practice Address - City:OAKTON
Practice Address - State:VA
Practice Address - Zip Code:22124-1761
Practice Address - Country:US
Practice Address - Phone:571-529-6699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101059209207Q00000X, 207QA0505X, 208VP0000X, 171100000X, 204D00000X
AZ7879207Q00000X
MA49336207Q00000X, 204D00000X
NH14325207Q00000X, 204D00000X, 204D00000X
MDD54153208VP0000X, 207Q00000X, 171100000X
MDD541153204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No171100000XOther Service ProvidersAcupuncturist
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD44387Medicare UPIN