Individual provider Active NPI

Lauren Reynolds

  • Student in an Organized Health Care Education/Training Program
  • Dayton, OH
National Provider Identifier
1053984369
Registry record updated Jul 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
117 Health Sciences BLDG 3640 Colonel Glenn Hwy
Dayton, OH 45435-0001
Phone
(937) 775-3458
NPI assigned
Jul 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X OH Primary

Addresses

Primary practice location

117 Health Sciences BLDG 3640 Colonel Glenn Hwy
Dayton, OH 45435-0001

Mailing address

925 Saddle Dr
Salem, VA 24153-2645
Phone (540) 520-5846

Other identifiers 1

IdentifierTypeStateIssuer
A1-357742MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL reynolds.264@wright.edu

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

NPI Registry JSON

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

{
    "created_epoch": "1626998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626998400000",
    "number": "1053984369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 SADDLE DR",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241532645",
            "telephone_number": "540-520-5846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 HEALTH SCIENCES BLDG 3640 COLONEL GLENN HWY",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454350001",
            "telephone_number": "937-775-3458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "LAUREN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-23",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A1-357742",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "reynolds.264@wright.edu",
            "affiliation": "N",
            "endpointDescription": "University email",
            "address_1": "117 Health Sciences Bldg 3640 Colonel Glenn Hwy",
            "city": "Dayton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454350001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2021; 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.