Individual provider Active NPI

James Reynolds, FNP-C

  • Primary Care Nurse Practitioner
  • Gilbert, AZ
National Provider Identifier
1235905662
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
246936 Issued in AZ
Practice address
2285 E Appleby Rd
Gilbert, AZ 85298-9307
Phone
(480) 888-6556
NPI assigned
Nov 27, 2023
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 246936 AZ
Primary Care Nurse Practitioner 363LP2300X 246936 AZ Primary

Addresses

Primary practice location

2285 E Appleby Rd
Gilbert, AZ 85298-9307

Mailing address

2285 E Appleby Rd
Gilbert, AZ 85298-9307
Phone (480) 888-6556

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20240229002290 AZ Practitioner - Nurse Practitioner 0840635843 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
246936AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Heavens Medical PLC Single Specialty CurrentSince Jan 15, 2024 Accepting new patients
Prohealth Integrative Medicine, PLLC CurrentSince Dec 24, 2023 Accepting new patients
Heavens Urgent Care LLC Single Specialty CurrentSince Jan 15, 2024 Accepting new patients

Locations

95 S Idaho Rd
Ste 140
Apache Junction, AZ 85119
Phone (480) 444-1160

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21922/brand/1/csg/1/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1701043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1235905662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2285 E APPLEBY RD",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852989307",
            "telephone_number": "480-888-6556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2285 E APPLEBY RD",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852989307",
            "telephone_number": "480-888-6556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "JAMES",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-11-27",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "246936",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "AZ",
            "license": "246936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.