Active NPI
Patrice W. Reynolds, M.D.
- Pediatrics Physician
- Philadelphia, PA
National Provider Identifier
1265472898
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD425381
- Practice address
- 5000 Woodland Ave
Philadelphia, PA 19143-5137 - Phone
- (215) 726-9807
- Fax
- (215) 726-0424
- NPI assigned
- Jun 8, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD425381 | PA | Primary |
Addresses
Primary practice location
5000 Woodland Ave
Philadelphia, PA 19143-5137
Mailing address
432 N 6TH St
Philadelphia, PA 19123-4004
Phone (215) 925-2400
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0492593 | Other | PA | CIGNA |
| 101142943-01 | Other | PA | AMERICHOICE |
| 101142943 | Medicaid | PA | |
| 30021095 | Other | PA | KEYSTONE MERCY |
| 1659165 | Other | PA | HIGHMARK BLUE SHIELD |
| 1659165 | Other | PA | PERSONAL CHOICE |
| 2335423000 | Other | PA | IBC, KEYSTONE |
| 3767374 | Other | PA | AETNA |
| 03226 | Other | PA | HEALTH PARTNERS |
| 9376776 | Other | PA | PHCS |
| 2490677 | Other | PA | UNITED HEALTHCARE |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1372809600000",
"number": "1265472898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "432 N 6TH ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191234004",
"telephone_number": "215-925-2400",
"fax_number": "215-925-9162"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5000 WOODLAND AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191435137",
"telephone_number": "215-726-9807",
"fax_number": "215-726-0424"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOLDS",
"first_name": "PATRICE",
"middle_name": "W.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-08",
"last_updated": "2013-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "PA",
"license": "MD425381",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "0492593",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICHOICE",
"identifier": "101142943-01",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "101142943",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KEYSTONE MERCY",
"identifier": "30021095",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BLUE SHIELD",
"identifier": "1659165",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PERSONAL CHOICE",
"identifier": "1659165",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IBC, KEYSTONE",
"identifier": "2335423000",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "3767374",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "03226",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHCS",
"identifier": "9376776",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "2490677",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.