Individual provider Active NPI

Brittany Lane Reynolds, MSN, APRN, FNP-C

  • Family Nurse Practitioner
  • Jonesboro, AR
National Provider Identifier
1093309106
Registry record updated Jun 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
214914 Issued in AR
Practice address
1150 E Matthews Ave Ste 101a
Jonesboro, AR 72401-4356
Phone
(870) 243-0424
Fax
(534) 248-4225
NPI assigned
Mar 1, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 214914 AR
Family Nurse Practitioner 363LF0000X 214914 AR Primary

Addresses

Primary practice location

1150 E Matthews Ave Ste 101a
Jonesboro, AR 72401-4356

Mailing address

2665 Bricky Rd South
Bee Branch, AR 72013
Phone (501) 581-8252

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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

Enrollment IDStateProvider typePAC IDDetails
I20210914000591 AR Practitioner - Nurse Practitioner 9931505195 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
214914ARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Renew Mental Health and Wellness LLC Psychiatric/Mental Health CurrentSince Sep 3, 2021 Accepting new patients
Renew Mental Health and Wellness, LLC CurrentSince Sep 3, 2021 Accepting new patients
Quality Healthcare Resources LLC Family CurrentSince Apr 18, 2022 Accepting new patients

Locations

1150 E Matthews Ave
Ste 101A
Jonesboro, AR 72401
Phone (870) 243-0424

2200 S Bowman Rd
Ste A
Little Rock, AR 72211
Phone (501) 558-4100

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": "1614556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1093309106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2665 BRICKY RD SOUTH",
            "city": "BEE BRANCH",
            "state": "AR",
            "postal_code": "72013",
            "telephone_number": "501-581-8252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 E MATTHEWS AVE STE 101A",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724014356",
            "telephone_number": "870-243-0424",
            "fax_number": "534-248-4225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "BRITTANY",
        "middle_name": "LANE",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-01",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AR",
            "license": "214914",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "214914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

Verify at the official NPI Registry.