Leah R Reynolds, P.A.-C.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

6370 Issued in GA

Practice address

4245 Johns Creek Pkwy
Ste D
Suwanee, GA 30024-9121

Phone

(770) 495-3820

Fax

(770) 495-3825

NPI assigned

Mar 25, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Physician Assistant

Education

Texas Tech University Health Science Center School of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Georgia Surgical Professional Services LLCGroup PAC ID 3375774011, 38 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Georgia Surgical Professional Services, LLC

  • Otolaryngology Physician
  • Atlanta, GA
  • NPI 1801224506
  Medicare reassignment Care Compare group
• The Emory Clinic Inc

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1396798229
  Medicare reassignment NPD

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

{
    "created_epoch": "1143244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485907200000",
    "number": "1124088851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4245 JOHNS CREEK PKWY",
            "address_2": "STE D",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300249121",
            "telephone_number": "770-495-3820",
            "fax_number": "770-495-3825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4245 JOHNS CREEK PKWY",
            "address_2": "STE D",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300249121",
            "telephone_number": "770-495-3820",
            "fax_number": "770-495-3825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "LEAH",
        "middle_name": "R",
        "credential": "P.A.-C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-25",
        "last_updated": "2017-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "3344",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "6370",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003121895D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003121895F",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00380758",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "069627",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maryam Rehman
• David M Reingold, M.D.
• Relational Wellness LLC (Relate Well Solutions)
• Reliance Medical Center Inc
• Resurgens, LLC (Resurgens Orthopaedics)
• Michael H Reznik, D.D.S
• Richard Heggeland, OD, PC (Optical Insights)
• Robert Lawrence Richard, MD
• Delaney Richards, RBT
• Caroline Shaw Richardson Miller, LPMT, MT-BC

• Medical Physician Assistant in Suwanee, GA
• Providers in Suwanee, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.