Individual provider Active NPI

David Nowell Reynolds, M.D.

  • Internal Medicine Physician
  • Louisville, KY
National Provider Identifier
1093988511
Registry record updated Jan 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
44768 Issued in KY
Practice address
3991 Dutchmans LN Ste 205
Louisville, KY 40207-4723
Phone
(502) 899-6170
Fax
(502) 899-6179
NPI assigned
Apr 4, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 44768 KY Primary

Addresses

Primary practice location

3991 Dutchmans LN Ste 205
Louisville, KY 40207-4723

Mailing address

PO Box 776351
Chicago, IL 60677-6351
Phone (502) 588-9490

Other practice location 1

2213 Wrocklage Ave
Louisville, KY 40205-2116
Phone (502) 287-1132

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address dreynolds139929@direct.nortonhealthcare.org
FHIR URL https://epicsoap.nortonhealthcare.org/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20180410003115 KY Practitioner - Internal Medicine 8325276553 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44768KYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. Internal Medicine CurrentSince Mar 1, 2018 Accepting new patients
Community Medical Associates, Inc. Current Accepting new patients
Community Medical Associates, Inc. CurrentSince Mar 1, 2018 Accepting new patients
Major Hospital Past Accepting new patients

Locations

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

3991 Dutchmans Ln
Ste 205
Louisville, KY 40207
Phone (502) 899-6170

Organizations & group practices 4

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": "1207267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611187200000",
    "number": "1093988511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3991 DUTCHMANS LN STE 205",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074723",
            "telephone_number": "502-899-6170",
            "fax_number": "502-899-6179"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2213 Wrocklage Ave",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402052116",
            "country_code": "US",
            "telephone_number": "502-287-1132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "DAVID",
        "middle_name": "NOWELL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-04",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "44768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dreynolds139929@direct.nortonhealthcare.org",
            "affiliation": "N",
            "address_1": "3991 Dutchmans Ln Ste 205",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402074723",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicsoap.nortonhealthcare.org/",
            "affiliation": "N",
            "address_1": "3991 Dutchmans Ln Ste 205",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402074723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.