Active NPI
Robert Francis Reynolds, PH.D.
- Clinical Psychologist
- Middletown, CT
National Provider Identifier
1114101706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 001807
- Practice address
- 770 Saybrook Rd
Building B
Middletown, CT 06457-4739 - Phone
- (860) 343-0227
- Fax
- (860) 343-8511
- NPI assigned
- Dec 19, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 001807 | CT | Primary |
Addresses
Primary practice location
770 Saybrook Rd
Building B
Middletown, CT 06457-4739
Mailing address
77O Saybrook Road
BLDG. B
Middletown, CT 06457
Phone (860) 343-0227
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001807 | CT | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1198022400000",
"number": "1114101706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "77O SAYBROOK ROAD",
"address_2": "BLDG. B",
"city": "MIDDLETOWN",
"state": "CT",
"postal_code": "06457",
"telephone_number": "860-343-0227",
"fax_number": "860-343-8511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "770 SAYBROOK RD",
"address_2": "BUILDING B",
"city": "MIDDLETOWN",
"state": "CT",
"postal_code": "064574739",
"telephone_number": "860-343-0227",
"fax_number": "860-343-8511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOLDS",
"first_name": "ROBERT",
"middle_name": "FRANCIS",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-12-19",
"last_updated": "2007-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CT",
"license": "001807",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middletown, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.