Active NPI
Teresa A Reynolds, MD
- Rheumatology Physician
- Wichita, KS
National Provider Identifier
1205871712
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rheumatology Physician
- License
- 04-22267
- Practice address
- 3311 E Murdock St
Wichita, KS 67208-3054 - Phone
- (316) 689-9188
- Fax
- (316) 689-9140
- NPI assigned
- Jun 18, 2006
- Last updated
- Jun 24, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 22267 | KS | |
| Rheumatology Physician | 207RR0500X | 04-22267 | KS | Primary |
Addresses
Primary practice location
3311 E Murdock St
Wichita, KS 67208-3054
Mailing address
PO Box 8035
Wichita, KS 67208-0035
Phone (316) 689-9135
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12149395 | Other | KS | MULTIPLAN |
| 200145 | Other | KS | HPK |
| 16918 | Other | KS | COVENTRY |
| 775 | Other | KS | PHS |
| 100208490A | Medicaid | KS | |
| 018255 | Other | KS | BCBS |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22267 | KS | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435104000000",
"number": "1205871712",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8035",
"city": "WICHITA",
"state": "KS",
"postal_code": "672080035",
"telephone_number": "316-689-9135",
"fax_number": "316-689-9102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3311 E MURDOCK ST",
"city": "WICHITA",
"state": "KS",
"postal_code": "672083054",
"telephone_number": "316-689-9188",
"fax_number": "316-689-9140"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOLDS",
"first_name": "TERESA",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-18",
"last_updated": "2015-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "KS",
"license": "22267",
"primary": false
},
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "KS",
"license": "04-22267",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MULTIPLAN",
"identifier": "12149395",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HPK",
"identifier": "200145",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COVENTRY",
"identifier": "16918",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHS",
"identifier": "775",
"state": "KS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100208490A",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "018255",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wichita, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.