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General NPI Number Information
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NPI Number | 1427009968
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Entity Type | Individual
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Provider Name | THERESA MARIE REINER MASSEY PA-C
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Gender | Female
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 07/14/2021
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Provider Practice Location Address
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Address Line | 501 S SHARON AMITY RD STE 300
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City | CHARLOTTE
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State | NC
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Zip | 28211-0035
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Country | US
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Telephone | 704-377-2424
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Fax | 704-377-2687
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Provider Business Mailing Address
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Address Line | 501 S SHARON AMITY RD STE 300
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City | CHARLOTTE
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State | NC
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Zip | 28211-0035
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Country | US
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Telephone | 704-377-2424
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Fax | 704-377-2687
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 227900000X
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Taxonomy Name | Registered Respiratory Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA30116
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License Number State | DC
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0110-84616
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0101180
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License Number State | NC
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Taxonomy #5
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | C07896
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License Number State | MD
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Taxonomy #6
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 50-000766
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License Number State | OH
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