Tiffany Reynolds, NP

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

1017247 Issued in TX

Practice address

400 S Zang Blvd Ste 815
Dallas, TX 75208-6643

Phone

(844) 864-8928

Fax

(817) 549-7724

NPI assigned

May 15, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Bloom Integrative Wellness Center of South Lake, LLC

  • Women's Health Nurse Practitioner
  • Dallas, TX
  • NPI 1033831227
  Medicare reassignment NPD Authorized official
• Ayaba Med Spa, LLC

  • Women's Health Nurse Practitioner
  • Arlington, TX
  • NPI 1629774310
  NPD Authorized official
• Planned Parenthood Greater Memphis Region

  • Ambulatory Family Planning Facility
  • Memphis, TN
  • NPI 1881995173
  NPD
• Family Services of the Mid-South

  • Community/Behavioral Health Agency
  • Memphis, TN
  • NPI 1225103914
  NPD (past)
• Planned Parenthood Greater Memphis Region

  • Ambulatory Surgical Clinic/Center
  • Memphis, TN
  • NPI 1447209820
  NPD (past)

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

{
    "created_epoch": "1557878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1114583093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "539 W COMMERCE ST # 4488",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752081953",
            "telephone_number": "844-864-8928",
            "fax_number": "817-549-7724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S ZANG BLVD STE 815",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752086643",
            "telephone_number": "844-864-8928",
            "fax_number": "817-549-7724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "TIFFANY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-15",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MD",
            "license": "R237701",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MD",
            "license": "R2337701",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "TX",
            "license": "1017247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nietta Reynolds
• Priscilla Paige Reynolds, APN,FNP
• Regina Reynolds
• Sandra Reynolds
• Scarlett Renee' Reynolds, PA-C
• William Eric Reynolds, LPC
• Brian Reys, MS, CGC
• Reza Assadollah, DCNP, PLLC
• Reza Nabavi, P.T., P.C.
• Sadaf Yahyai Rezaee

• Women's Health Nurse Practitioner in Dallas, TX
• Providers in Dallas, TX by specialty
• Women's Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.