Individual provider Active NPI

Miriam Rose Baker Reynolds, PHD

  • School Psychologist
  • Bend, OR
National Provider Identifier
1144180134
Registry record updated Nov 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
Practice address
520 NW Wall St
Bend, OR 97703-2608
Phone
(541) 355-1100
NPI assigned
Nov 13, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X OR Primary

Addresses

Primary practice location

520 NW Wall St
Bend, OR 97703-2608

Mailing address

520 NW Wall St
Bend, OR 97703-2608
Phone (541) 355-6906

Other practice location 1

60880 Brookswood Blvd
Bend, OR 97702-2516
Phone (541) 355-6906

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1762992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763078400000",
    "number": "1144180134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 NW WALL ST",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977032608",
            "telephone_number": "541-355-6906",
            "fax_number": "541-355-1510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 NW WALL ST",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977032608",
            "telephone_number": "541-355-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "60880 Brookswood Blvd",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "977022516",
            "country_code": "US",
            "telephone_number": "541-355-6906",
            "fax_number": "541-355-1510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "MIRIAM",
        "middle_name": "ROSE BAKER",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-13",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.