NPIMap

Individual provider Active NPI

Michael K Reynolds, MD

  • Family Medicine Physician
  • Alberta, VA
National Provider Identifier
1104822386
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101236563 Issued in VA
Practice address
8380 Boydton Plank Rd
Alberta, VA 23821-2851
Phone
(434) 949-7211
Fax
(434) 447-2240
NPI assigned
Jun 22, 2005
Last updated
Nov 15, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101236563 VA Primary

Addresses

Primary practice location

8380 Boydton Plank Rd
Alberta, VA 23821-2851

Mailing address

514 W Atlantic St
South Hill, VA 23970-1906
Phone (434) 447-6969

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040909001381 VA Practitioner - Family Practice 6103892179 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Virginia School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

8380 Boydton Plank Rd
Alberta, VA 23821-2851
Phone (434) 949-7211

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101236563VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Virginia Health Services Inc Current Accepting new patients
Central Virginia Health Services Inc CurrentSince Feb 13, 2024 Accepting new patients
Central Virginia Health Services Inc CurrentSince Feb 13, 2024 Accepting new patients
Central Virginia Health Services Inc Past Accepting new patients

Locations

8380 Boydton Plank Rd
Alberta, VA 23821
Phone (434) 949-7211

25892 N James Madison Hwy
New Canton, VA 23123
Phone (434) 581-3271

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1104822386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 W ATLANTIC ST",
            "city": "SOUTH HILL",
            "state": "VA",
            "postal_code": "239701906",
            "telephone_number": "434-447-6969",
            "fax_number": "434-447-2240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8380 BOYDTON PLANK RD",
            "city": "ALBERTA",
            "state": "VA",
            "postal_code": "238212851",
            "telephone_number": "434-949-7211",
            "fax_number": "434-447-2240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "MICHAEL",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101236563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alberta, VA

Sources for this page

Verify at the official NPI Registry.