Michael Warren Reynolds, RPA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-01036 Issued in NC

Practice address

3101 Latrobe Dr
Charlotte, NC 28211-4849

Phone

(704) 376-7362

Fax

(704) 376-1939

NPI assigned

Mar 13, 2007

Sex

Male

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 NC

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carolina Medicorp Enterprises LLCGroup PAC ID 0648174904, 184 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mreynolds1233964@direct.novanthealth.org

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.

• Carolina Medicorp Enterprises, LLC

  • Urgent Care Clinic/Center
  • Charlotte, NC
  • NPI 1760950646
  Medicare reassignment Care Compare group
• Emergency Medicine Physicians of Mecklenburg County, PLLC

  • Emergency Medicine Physician
  • Charlotte, NC
  • NPI 1912232182
  Medicare reassignment
• Carolina Medicorp Enterprises, LLC

  • Urgent Care Clinic/Center
  • Salisbury, NC
  • NPI 1053296509
  NPD
• Carolina Medicorp Enterprises, LLC

  • Urgent Care Clinic/Center
  • Asheville, NC
  • NPI 1235014796
  NPD
• Carolina Medicorp Enterprises Inc

  • Pediatrics Physician
  • Charlotte, NC
  • NPI 1417497504
  NPD (past)
• Emergency Medicine Physicians of Iredell County, PLLC

  • Emergency Medicine Physician
  • Statesville, NC
  • NPI 1104151109
  NPD (past)
• Piedmont Emergency Medical Associates, PA

  • Emergency Medicine Physician
  • Charlotte, NC
  • NPI 1801822523
  NPD (past)

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1215060835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 LATROBE DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282114849",
            "telephone_number": "704-376-7362",
            "fax_number": "704-376-1939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 LATROBE DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282114849",
            "telephone_number": "704-376-7362",
            "fax_number": "704-376-1939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "MICHAEL",
        "middle_name": "WARREN",
        "credential": "RPA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "011759",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-01036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayce Bock Reynolds
• Kevin Reynolds, DO
• Kimberley Reynolds, M.ED., L.P.C.
• Mark Stephen Reynolds, M.D.
• Matthew Reynolds, MD
• Michaela Reynolds, LCSW
• Pauline Reynolds, FNP
• Sarah H. Reynolds, MD
• Sophie Annaliese Reynolds
• Stacy Lynn Reynolds, MD

• Physician Assistant in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.