Reubean Alvis Reynolds, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

025822 Issued in GA

Practice address

81 Upper Riverdale Rd SW
Suite 210
Riverdale, GA 30274-2634

Phone

(770) 996-1200

Fax

(770) 907-7492

NPI assigned

Jul 31, 2006

Last updated

Sep 21, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Peach Family Medicine P.C.

  • Family Medicine Physician
  • McDonough, GA
  • NPI 1245266535
  NPD (past)
• Piedmont Providers LLC

  • Internal Medicine Physician
  • Jasper, GA
  • NPI 1548273592
  NPD (past)

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316563200000",
    "number": "1205842374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 962380",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302966921",
            "telephone_number": "770-996-1200",
            "fax_number": "770-907-7492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 UPPER RIVERDALE RD SW",
            "address_2": "SUITE 210",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742634",
            "telephone_number": "770-996-1200",
            "fax_number": "770-907-7492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "REUBEAN",
        "middle_name": "ALVIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2011-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "025822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000607945A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Reliable Mobile Drug Testing LLC
• Reliance Healthcare Services Inc
• Renal Treatment Centers Mid Atlantic, Inc. (Southern Crescent Dialysis Center)
• Restore First Health Riverdale LLC
• Resurgens, LLC (nMotion)
• Richard a. Stappenbeck, M.D., P.C.
• Right Choice Enterprises LLC
• Riverdale Anesthesia Associates, PC
• Riverdale Anesthesia Services LLC
• Riverdale Dental Smiles

• Obstetrics & Gynecology Physician in Riverdale, GA
• Providers in Riverdale, GA by specialty
• Obstetrics & Gynecology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2011; 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.