Individual provider Active NPI

Jennifer Reynolds, APRN-C

  • Family Nurse Practitioner
  • Tallahassee, FL
National Provider Identifier
1215822283
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11040102 Issued in FL
Practice address
3301 Thomasville Rd Ste 102
Tallahassee, FL 32308-7941
Phone
(850) 391-9622
NPI assigned
Jun 10, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11040102 FL Primary

Addresses

Primary practice location

3301 Thomasville Rd Ste 102
Tallahassee, FL 32308-7941

Mailing address

3301 Thomasville Rd Ste 102
Tallahassee, FL 32308-7941

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20250729000889 FL Practitioner - Nurse Practitioner 4880101450 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11040102FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Charles W Kent, M.D. Inc. CurrentSince Jun 9, 2025 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients
Tallahassee Vein & Face Clinic Inc Past Accepting new patients

Locations

3301 Thomasville Rd
Ste 102
Tallahassee, FL 32308
Phone (850) 391-9622

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1749513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1215822283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 THOMASVILLE RD STE 102",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323087941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 THOMASVILLE RD STE 102",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323087941",
            "telephone_number": "850-391-9622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "JENNIFER",
        "credential": "APRN-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-10",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11040102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.