Nathan Samuel Reynolds, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT7014 Issued in MS

Practice address

103 Medical Park FL 1
Hattiesburg, MS 39401-9042

Phone

(601) 268-5757

Fax

(601) 579-5220

NPI assigned

Dec 1, 2020

Last updated

Jan 27, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nreynolds106489@directpatientrecord.com

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.

• Hattiesburg Clinic PA

  • Multi-Specialty Clinic/Center
  • Hattiesburg, MS
  • NPI 1740213446
  Medicare reassignment NPD
• Hattiesburg Clinic, PA

  dba Flowood Primary Care

  • Primary Care Clinic/Center
  • Flowood, MS
  • NPI 1912600354
  NPD
• State of Mississippi - University of Mississippi Medical Center

  dba Holmes County Hospital and Clinic

  • Critical Access Hospital
  • Lexington, MS
  • NPI 1386630705
  NPD (past)

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

{
    "created_epoch": "1606780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611705600000",
    "number": "1114522828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-268-5757",
            "fax_number": "601-579-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 MEDICAL PARK FL 1",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394019042",
            "telephone_number": "601-268-5757",
            "fax_number": "601-579-5220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "NATHAN",
        "middle_name": "SAMUEL",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-01",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT7014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nreynolds106489@directpatientrecord.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "103 Medical Park Fl 1",
            "city": "Hattiesburg",
            "state": "MS",
            "country_code": "US",
            "postal_code": "394019042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• D Enise W Reynolds, M.D.
• Deidre Reynolds, PHARMD
• Katherine Elizabeth Reynolds, OD
• Kimberly Reynolds, PT, DPT
• Lauren McKenzy Reynolds
• Suyon Rhee, DPM
• Erin T. Rhodes, D.D.S.
• Lynne Rhodes, SLP
• Seth Isaac Rhodes, PA-C
• Spencer Avery Rhodes, DO

• Physical Therapist in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Physical Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.