Individual provider Active NPI

Noah David Reynolds, DO

  • Pediatrics Physician
  • Omaha, NE
National Provider Identifier
1083107411
Registry record updated Jun 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
8300 Issued in NE
Practice address
982185 Nebraska Medical Ctr
Omaha, NE 68198-2815
Phone
(402) 559-5380
NPI assigned
Jun 11, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 8300 NE Primary

Addresses

Primary practice location

982185 Nebraska Medical Ctr
Omaha, NE 68198-2815

Mailing address

982185 Nebraska Medical Ctr
Omaha, NE 68198-2815

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210813002350 IA Practitioner - Pediatric Medicine 4880098722 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8300NEMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iowa Physicians Clinic Medical Foundation Pediatrics CurrentSince Aug 30, 2021 Accepting new patients
St Luke'S Methodist Hospital Current Accepting new patients
Nebraska Medical Center Past Accepting new patients

Locations

3625 N Ankeny Blvd
Ste F
Ankeny, IA 50023
Phone (515) 964-4600

4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950

4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150

40 E Hickman Rd
Waukee, IA 50263
Phone (515) 216-2918

1776 Westlakes Pkwy
Ste 400
West Des Moines, IA 50266
Phone (515) 241-6161

6000 University Ave
Ste 100
West Des Moines, IA 50266
Phone (515) 241-2500

1271 8th St
Ste 100
West Des Moines, IA 50265
Phone (515) 224-4993

Interoperability endpoints

  • Direct secure messaging: nreynolds582270@direct.unitypoint.org

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": "1528675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528675200000",
    "number": "1083107411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "982185 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681982815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "982185 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681982815",
            "telephone_number": "402-559-5380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "NOAH",
        "middle_name": "DAVID",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-11",
        "last_updated": "2018-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NE",
            "license": "8300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.