Active NPI
James Brandon Reynolds, M.ED., ATC
- Athletic Trainer
- Demorest, GA
National Provider Identifier
1184765646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 0395
- Practice address
- 1021 Central Ave
Demorest, GA 30535-5252 - Phone
- (706) 778-8500
- NPI assigned
- Feb 9, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 0395 | NC | Primary |
Addresses
Primary practice location
1021 Central Ave
Demorest, GA 30535-5252
Mailing address
5400 Ramsey St
Athletic Training
Fayetteville, NC 28311-1420
Phone (910) 630-7177
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
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0395 | NC | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Methodist University | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Medical Physician Assistant
- Fayetteville, NC
- NPI 1962809269
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693440000000",
"number": "1184765646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5400 RAMSEY ST",
"address_2": "ATHLETIC TRAINING",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283111420",
"telephone_number": "910-630-7177",
"fax_number": "910-630-7676"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1021 CENTRAL AVE",
"city": "DEMOREST",
"state": "GA",
"postal_code": "305355252",
"telephone_number": "706-778-8500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOLDS",
"first_name": "JAMES",
"middle_name": "BRANDON",
"credential": "M.ED., ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-09",
"last_updated": "2023-08-31",
"certification_date": "2023-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NC",
"license": "0395",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Demorest, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.