Individual provider Active NPI

Gina Maureen Reynolds, R.N.

  • Case Management Registered Nurse
  • Dublin, OH
National Provider Identifier
1023202595
Registry record updated Aug 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management Registered NurseTaxonomy code 163WC0400X
License
28111264A Issued in IN
Practice address
5555 Glendon CT
Dublin, OH 43016-3249
Phone
(574) 256-7308
Fax
(574) 256-7314
NPI assigned
Aug 28, 2007
Last updated
Aug 28, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Registered Nurse 163WC0400X 28111264A IN Primary
Rehabilitation Registered Nurse 163WR0400X 00019239 OH

Addresses

Primary practice location

5555 Glendon CT
Dublin, OH 43016-3249

Mailing address

PO Box 1086
Mishawaka, IN 46546-1086
Phone (574) 256-7308

Other identifiers 1

IdentifierTypeStateIssuer
2811264AOtherININDIANA RN LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
28111264AINMDCase Management Registered Nurse
00019239OHMDRehabilitation Registered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188259200000",
    "number": "1023202595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1086",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465461086",
            "telephone_number": "574-256-7308",
            "fax_number": "574-256-7314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 GLENDON CT",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430163249",
            "telephone_number": "574-256-7308",
            "fax_number": "574-256-7314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "GINA",
        "middle_name": "MAUREEN",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-28",
        "last_updated": "2007-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "IN",
            "license": "28111264A",
            "primary": true
        },
        {
            "code": "163WR0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Rehabilitation",
            "state": "OH",
            "license": "00019239",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA  RN LICENSE",
            "identifier": "2811264A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.