Active NPI
William Reynolds
- Physical Therapist
- Vestal, NY
National Provider Identifier
1235767708
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 024693-1
- Practice address
- 4102 Vestal Rd
Vestal, NY 13850-3531 - Phone
- (607) 772-1598
- NPI assigned
- Mar 31, 2020
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 024693-1 | NY | Primary |
Addresses
Primary practice location
4102 Vestal Rd
Vestal, NY 13850-3531
Mailing address
4102 Vestal Rd
Vestal, NY 13850-3531
Phone (607) 772-1598
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| IOM923122709 | Other | HEALTH INSURANCE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | william.reynolds@ascension.org |
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 |
|---|---|---|---|
| 024693-1 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585612800000",
"number": "1235767708",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4102 VESTAL RD",
"city": "VESTAL",
"state": "NY",
"postal_code": "138503531",
"telephone_number": "607-772-1598"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4102 VESTAL RD",
"city": "VESTAL",
"state": "NY",
"postal_code": "138503531",
"telephone_number": "607-772-1598"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOLDS",
"first_name": "WILLIAM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-03-31",
"last_updated": "2020-03-31",
"certification_date": "2020-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "024693-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH INSURANCE",
"identifier": "IOM923122709",
"state": null
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "william.reynolds@ascension.org",
"affiliation": "N",
"endpointDescription": "email address",
"address_1": "835 Park Ave",
"city": "Binghamton",
"state": "NY",
"country_code": "US",
"postal_code": "139036015",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Vestal, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.