Active NPI
Albert C. Reynaud, MD
- Dermatology Physician
- Billings, MT
National Provider Identifier
1104924000
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 6051
- Practice address
- 801 N 29TH St
Billings, MT 59101-0905 - Phone
- (406) 238-2500
- NPI assigned
- Sep 21, 2006
- Last updated
- Dec 11, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 6051 | MT | Primary |
Addresses
Primary practice location
801 N 29TH St
Billings, MT 59101-0905
Mailing address
PO Box 35100
Billings, MT 59107-5100
Phone (406) 238-2500
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 102349700 | Other | WY | MDCD PIN |
| 0011254 | Other | MT | MDCD PIN |
| 312698 | Other | WY | BCBS PIN |
| 000093970 | Other | MT | BCBS PIN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6051 | MT | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frances Mahon Deaconess Hospital | Past | Accepting new patients | |
| Pinnacle Dermatology, SC | Dermatology | Past | Accepting new patients |
Organizations & group practices 2
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1418256000000",
"number": "1104924000",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 35100",
"city": "BILLINGS",
"state": "MT",
"postal_code": "591075100",
"telephone_number": "406-238-2500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 N 29TH ST",
"city": "BILLINGS",
"state": "MT",
"postal_code": "591010905",
"telephone_number": "406-238-2500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNAUD",
"first_name": "ALBERT",
"middle_name": "C.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-21",
"last_updated": "2014-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "MT",
"license": "6051",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MDCD PIN",
"identifier": "102349700",
"state": "WY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MDCD PIN",
"identifier": "0011254",
"state": "MT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PIN",
"identifier": "312698",
"state": "WY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PIN",
"identifier": "000093970",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Billings, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.