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MAXIE REAVIS DO
NPI 1114706983
Student in an Organized Health Care Education/Training Program in Lutz, FL

Active since September 21, 2023PECOS Enrolled
21808 STATE ROAD 54, LUTZ, FL 33549(509) 452-5100 Get Directions Write a Review

NPPES record last updated: March 25, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Maxie Reavis Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MAXIE REAVIS DO (NPI 1114706983) is an individual student in an organized health care education/training program in Lutz, Florida and active in the NPI registry since September 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1114706983
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameMAXIE REAVISCredential: DO
Location Address21808 STATE ROAD 54Lutz, FL 33549-6923
Mailing Address2101 Steptoe St Apt 233Richland, WA 99352-8557 · (206) 226-7357
Phone(509) 452-5100
Sole ProprietorNo
Enumeration DateSeptember 21, 2023
Last NPPES UpdateMarch 25, 2024
NPPES CertifiedMarch 25, 2024
✔ NPI 1114706983 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
21808 STATE ROAD 54, Lutz, FL 33549
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Maxie Reavis Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HELEN FANTA MD
Student in an Organized Health Care Education/Training Program
21808 STATE ROAD 54
LUTZ, FL 33549
Hillsborough County (813) 922-8621
DAIMARYS PEREZ
Student in an Organized Health Care Education/Training Program
21808 STATE ROAD 54
LUTZ, FL 33549
Hillsborough County (813) 922-8621
DR. KAYLAH LEEIGH TURPIN DNP
Nurse Practitioner (Psychiatric/Mental Health)
21808 STATE ROAD 54
LUTZ, FL 33549
Hillsborough County (727) 820-8200
MILLIN SEKHON
Psychiatry & Neurology (Psychiatry)
21808 STATE ROAD 54
LUTZ, FL 33549
Hillsborough County (866) 762-1743
JAMES DONATO TUTTLE MD
Student in an Organized Health Care Education/Training Program
21808 STATE ROAD 54
LUTZ, FL 33549
Hillsborough County (727) 315-8612
JULIA MCCANN DO
Student in an Organized Health Care Education/Training Program
21808 STATE ROAD 54
LUTZ, FL 33549
Hillsborough County (813) 922-8621
AMY AMOAH MD
Student in an Organized Health Care Education/Training Program
21808 STATE ROAD 54
LUTZ, FL 33549
Hillsborough County (813) 922-8621
DR. VANESSA LYNN DRUST MD
Student in an Organized Health Care Education/Training Program
21808 STATE ROAD 54
LUTZ, FL 33549
Hillsborough County (813) 922-8621

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Maxie Reavis's NPI number?

The NPI number for Maxie Reavis is 1114706983. It was assigned to this individual provider in the NPPES registry on September 21, 2023.

Where is Maxie Reavis located?

Maxie Reavis practices at 21808 State Road 54, Lutz, FL 33549. The listed phone number is (509) 452-5100.

What is Maxie Reavis's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Maxie Reavis enrolled in Medicare?

Yes. Maxie Reavis is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Maxie Reavis was last updated on March 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.