Nicole Marie Reynolds, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3979 Issued in SC

Practice address

340 Medical Pkwy Ste 200
Greer, SC 29650-2441

Phone

(864) 797-7940

Fax

(864) 797-9402

NPI assigned

Aug 20, 2012

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

Medicare fee-for-service enrollment

Enrolled in SC

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

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prisma Health University Medical GroupGroup PAC ID 8325950983, 2,467 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Prisma Health Greenville Memorial Hospital Hospital, Greenville, SC, CCN 420078
• Prisma Health Greer Memorial Hospital Hospital, Spartanburg, SC, CCN 420033
• Prisma Health Patewood Hospital Hospital, Greenville, SC, CCN 420102
• Prisma Health Hillcrest Hospital Hospital, Simpsonville, SC, CCN 420037
• Prisma Health North Greenville Ltach Long-term care hospital, Travelers Rest, SC, CCN 422008

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/uc41222_advuroswflorida
• Direct secure messaging: nreynolds527019@direct.ghs.myhfn.org

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.

• Prisma Health University Medical Group

  • Family Medicine Physician
  • Greenville, SC
  • NPI 1295763217
  Medicare reassignment Care Compare group NPD (past)
• Prisma Health University Medical Group

  • Gynecology Physician
  • Greer, SC
  • NPI 1003619313
  NPD
• Prisma Health University Medical Group

  • Nurse Practitioner
  • Greenville, SC
  • NPI 1053786483
  NPD
• Advanced Urology Institute, LLC

  • Urology Physician
  • Oxford, FL
  • NPI 1023447935
  NPD
• Advanced Urology Institute, LLC

  • Durable Medical Equipment & Medical Supplies
  • Inverness, FL
  • NPI 1700024163
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Prisma Health-Upstate

  • General Acute Care Hospital
  • Greenville, SC
  • NPI 1033664909
  Care Compare affiliation
• Prisma Health-Upstate

  • Medically Fragile Infants and Children Day Care
  • Greenville, SC
  • NPI 1093168064

  Hospital

  Care Compare affiliation
• Prisma Health-Upstate

  • General Acute Care Hospital
  • Greenville, SC
  • NPI 1114473212
  Care Compare affiliation
• Prisma Health-Upstate

  • General Acute Care Hospital
  • Greenville, SC
  • NPI 1124574223
  Care Compare affiliation
• Prisma Health-Upstate

  • General Acute Care Hospital
  • Greenville, SC
  • NPI 1144775032
  Care Compare affiliation
• Prisma Health-Upstate

  • General Acute Care Hospital
  • Greenville, SC
  • NPI 1144914607
  Care Compare affiliation
• Prisma Health-Upstate

  • General Acute Care Hospital
  • Greenville, SC
  • NPI 1174079271
  Care Compare affiliation
• Prisma Health-Upstate

  • Radiology Clinic/Center
  • Greenville, SC
  • NPI 1235685330

  Hospital

  Care Compare affiliation
• Prisma Health-Upstate

  • General Acute Care Hospital
  • Simpsonville, SC
  • NPI 1265988364
  Care Compare affiliation
• Prisma Health-Upstate

  • Sleep Disorder Diagnostic Clinic/Center
  • Greenville, SC
  • NPI 1275086431

  Hospital

  Care Compare affiliation
• Prisma Health-Upstate

  • Multi-Specialty Clinic/Center
  • Greenville, SC
  • NPI 1285180307

  Hospital

  Care Compare affiliation
• Prisma Health-Upstate

  • Clinic/Center
  • Greenville, SC
  • NPI 1316492218

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1345420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634169600000",
    "number": "1124376355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE STE 401",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 MEDICAL PKWY STE 200",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296502441",
            "telephone_number": "864-797-7940",
            "fax_number": "864-797-9402"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "48 Centennial Way",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296054662",
            "country_code": "US",
            "telephone_number": "864-522-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-20",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9106821",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "3979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Resilient Roots Chiro LLC
• Restoration Path Home Care Services, LLC
• Reba Revan, CST
• Drew Reynolds, RN
• Edward Hammond Reynolds Jr., B.S.
• Christopher John Richards, PA-C
• Clara Richards
• April Carpenter Richardson, M.D.
• Emilea Richardson, LMFT
• Laura Richardson

• Physician Assistant in Greer, SC
• Providers in Greer, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2021; 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.