Individual provider Active NPI

Jeffrey John Reynolds, OTR/L

  • Occupational Therapist
  • Hendersonville, TN
National Provider Identifier
1043221963
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT 1095 Issued in TN
Practice address
639 E Main St Ste B102
Hendersonville, TN 37075-2646
Phone
(615) 826-7113
Fax
(615) 826-7139
NPI assigned
Aug 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT 1095 TN Primary

Addresses

Primary practice location

639 E Main St Ste B102
Hendersonville, TN 37075-2646

Mailing address

639 E Main St Ste B102
Hendersonville, TN 37075-2646
Phone (615) 826-7113

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT 1095TNMDOccupational Therapist
1095TNMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
The Therapy Center of Hendersonville Occupational Therapist Past Accepting new patients
Let'S Talk Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043221963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "639 E MAIN ST STE B102",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370752646",
            "telephone_number": "615-826-7113",
            "fax_number": "615-826-7139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "639 E MAIN ST STE B102",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370752646",
            "telephone_number": "615-826-7113",
            "fax_number": "615-826-7139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "JEFFREY",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TN",
            "license": "OT 1095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hendersonville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.