Active NPI
Lawrence Reynolds, ATC, LAT
- Athletic Trainer
- Memphis, TN
National Provider Identifier
1215415450
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 1782
- Practice address
- 1115 East Getwell Loop Bill Jmurphy Football Complex
Memphis, TN 38152-0001 - Phone
- (901) 678-5384
- NPI assigned
- Jul 31, 2018
- 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 | 1782 | TN | Primary |
Addresses
Primary practice location
1115 East Getwell Loop Bill Jmurphy Football Complex
Memphis, TN 38152-0001
Mailing address
573 Arbor Hollow Cir Apt 208
Cordova, TN 38018-8096
Phone (513) 405-4154
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1782 | TN | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1532995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1532995200000",
"number": "1215415450",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "573 ARBOR HOLLOW CIR APT 208",
"city": "CORDOVA",
"state": "TN",
"postal_code": "380188096",
"telephone_number": "513-405-4154"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1115 EAST GETWELL LOOP BILL JMURPHY FOOTBALL COMPLEX",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381520001",
"telephone_number": "901-678-5384"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOLDS",
"first_name": "LAWRENCE",
"credential": "ATC, LAT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-07-31",
"last_updated": "2018-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "TN",
"license": "1782",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.