Shirley Deveere Reynolds

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209.018215 Issued in IL

Practice address

998 Inlet Loop
Coos Bay, OR 97420-4446

Phone

(773) 996-0242

NPI assigned

Sep 24, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Pacific Home Health and Hospice Home health agency, Coos Bay, OR, CCN 387135
• Bay Area Hospital Hospital, Coos Bay, OR, CCN 380090

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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

• Aceso Medical Clinic LLC

  • Family Nurse Practitioner
  • Coos Bay, OR
  • NPI 1790499663
  NPD Authorized official
• Daiya Healthcare PLLC

  • Internal Medicine Physician
  • Bellevue, WA
  • NPI 1477027381
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bay Area Hospital District

  dba Bay Area Hospital

  • General Acute Care Hospital
  • Coos Bay, OR
  • NPI 1225016561
  Care Compare affiliation
• Pacific Home Care Associates Inc.

  dba Pacific Home Health & Hospice

  • Home Health Agency
  • Coos Bay, OR
  • NPI 1851350086
  Care Compare affiliation

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

{
    "created_epoch": "1537747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537747200000",
    "number": "1073097242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "998 INLET LOOP",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974204446",
            "telephone_number": "773-996-0242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "998 INLET LOOP",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974204446",
            "telephone_number": "773-996-0242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "SHIRLEY",
        "middle_name": "DEVEERE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-24",
        "last_updated": "2018-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.018215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsay Marie Reeves, FNP-C
• Rhonnie Rego
• Laurie C Reis, LCSW
• Joandrea Leigh Renfrow, DMD
• Christina Lee Reyes
• Ronald Chan Reynon, PT
• Andrew J Rice, MD, PHD
• Steven D Richardson, DMD
• Warren Steven Richardson, MD
• Sharon Lee Richmond, LMT

• Nurse Practitioner in Coos Bay, OR
• Providers in Coos Bay, OR by specialty
• Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.