Active NPI
Amy Marie Reynolds
- Student in an Organized Health Care Education/Training Program
- Hixson, TN
National Provider Identifier
1053766675
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 106139971
- Practice address
- 6908 Creeklands LN
Hixson, TN 37343-2931 - Phone
- (423) 605-0104
- NPI assigned
- May 2, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 106139971 | TN | Primary |
Addresses
Primary practice location
6908 Creeklands LN
Hixson, TN 37343-2931
Mailing address
6908 Creeklands LN
Hixson, TN 37343-2931
Phone (423) 605-0104
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 106139971 | TN | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1462147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1462147200000",
"number": "1053766675",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6908 CREEKLANDS LN",
"city": "HIXSON",
"state": "TN",
"postal_code": "373432931",
"telephone_number": "423-605-0104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6908 CREEKLANDS LN",
"city": "HIXSON",
"state": "TN",
"postal_code": "373432931",
"telephone_number": "423-605-0104"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOLDS",
"first_name": "AMY",
"middle_name": "MARIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-05-02",
"last_updated": "2016-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "TN",
"license": "106139971",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hixson, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.