Jordann Marie Reynolds, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

199407 Issued in AK

Practice address

16941 N Eagle River Loop Rd Unit 4
Eagle River, AK 99577-7824

Phone

(907) 715-4993

NPI assigned

Sep 10, 2020

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 AK

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Summit Sunrise Counseling LLC

  • Clinical Social Worker
  • Eagle River, AK
  • NPI 1629820543
  Medicare reassignment Authorized official
• Codi, Inc.

  • Community/Behavioral Health Agency
  • Palmer, AK
  • NPI 1205267473
  NPD (past)

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

{
    "created_epoch": "1599696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1134734833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2001",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996452001",
            "telephone_number": "907-315-3515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16941 N EAGLE RIVER LOOP RD UNIT 4",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777824",
            "telephone_number": "907-715-4993"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11921 E Palmer Wasilla Hwy",
            "address_purpose": "LOCATION",
            "city": "Palmer",
            "state": "AK",
            "postal_code": "996458833",
            "country_code": "US",
            "telephone_number": "907-745-2634",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "JORDANN",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-10",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AK",
            "license": "199407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Reiland, LPC
• Christopher Reintsma, BA PSYCHOLOGY, CDC1
• Revive Infusion Clinic, LLC
• Alexis Reyes
• Clayton Reyes
• Emily Katherine Rhodes, LPTA
• Jenna Christine Rhodes, BHS BCABA
• Tracie Jean Rieker, PA-C
• Leonardo Manuel Rios-Andersen, D.M.D.
• Rise Nutrition LLC

• Clinical Social Worker in Eagle River, AK
• Providers in Eagle River, AK by specialty
• Clinical Social Worker in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; 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.