Individual provider Active NPI

Dawn Nadine Reynolds, M.D.

  • Psychiatry Physician
  • Farmington Hills, MI
National Provider Identifier
1073711040
Registry record updated Jul 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
430108835 Issued in MI
Practice address
28545 Orchard Lake Rd Ste a
Farmington Hills, MI 48334-2996
Phone
(248) 987-4060
Fax
(248) 987-7012
NPI assigned
Jul 11, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 430108835 MI Primary

Addresses

Primary practice location

28545 Orchard Lake Rd Ste a
Farmington Hills, MI 48334-2996

Mailing address

28545 Orchard Lake Rd Ste a
Farmington Hills, MI 48334-2996
Phone (248) 987-4060

Other identifiers 1

IdentifierTypeStateIssuer
4301088335OtherMISTATE OF MICHIGAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
430108835MIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System Current Accepting new patients
Sacred Heart Medical Centre PC Past Accepting new patients
Kamran F. Sheikh MD PC Past Accepting new patients

Locations

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

Organizations & group practices 3

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": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1073711040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28545 ORCHARD LAKE RD STE A",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483342996",
            "telephone_number": "248-987-4060",
            "fax_number": "248-987-7012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28545 ORCHARD LAKE RD STE A",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483342996",
            "telephone_number": "248-987-4060",
            "fax_number": "248-987-7012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "DAWN",
        "middle_name": "NADINE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-11",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "430108835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MICHIGAN",
            "identifier": "4301088335",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

Verify at the official NPI Registry.