Robert Christian Reynolds

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

3079 Harrison Ave Ste D
South Lake Tahoe, CA 96150-7976

Phone

(916) 783-5207

NPI assigned

Mar 14, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Sierra Mental Wellness Group

  • Community/Behavioral Health Agency
  • South Lake Tahoe, CA
  • NPI 1942332788
  NPD

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

{
    "created_epoch": "1741910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758931200000",
    "number": "1275333742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3079 HARRISON AVE STE D",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961507976",
            "telephone_number": "916-783-5207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3079 HARRISON AVE STE D",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961507976",
            "telephone_number": "916-783-5207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "ROBERT",
        "middle_name": "CHRISTIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-14",
        "last_updated": "2025-09-27",
        "certification_date": "2025-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela D Reagan, PT
• Alicea Ann Ledbetter Reddy, AMFT
• Kassi Reisbeck
• Erika Karina Remigio
• Hector Reyes, MS
• Austin Rhodes, EMT-B
• Anna Kathryn Richter, LMFT
• Tamara Riggs, PHARM D
• Ryan Peter Ritchie, MS,PT
• Rite of Passage Adolescent Treatment Centers and Schools, Inc. (California Qualifying Houses - Tallac)

• Case Manager/Care Coordinator in South Lake Tahoe, CA
• Providers in South Lake Tahoe, CA by specialty
• Case Manager/Care Coordinator in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.