Active NPI
Annie M Reynolds, DNP
- Family Nurse Practitioner
- Salem, OR
National Provider Identifier
1285205880
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- REYN-T5D62
- Practice address
- 1750 McGilchrist St SE Ste 130
Salem, OR 97302-1691 - Phone
- (971) 304-2200
- NPI assigned
- Jul 5, 2021
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | REYN-T5D62 | NC | Primary |
Addresses
Primary practice location
1750 McGilchrist St SE Ste 130
Salem, OR 97302-1691
Mailing address
1750 McGilchrist St SE Ste 130
Salem, OR 97302-1691
Phone (971) 304-2200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221107001475 | OR | Order and Referring Only - Nurse Practitioner | 9133595986 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| REYN-T5D62 | NC | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663200000000",
"number": "1285205880",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1750 MCGILCHRIST ST SE STE 130",
"city": "SALEM",
"state": "OR",
"postal_code": "973021691",
"telephone_number": "971-304-2200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1750 MCGILCHRIST ST SE STE 130",
"city": "SALEM",
"state": "OR",
"postal_code": "973021691",
"telephone_number": "971-304-2200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOLDS",
"first_name": "ANNIE",
"middle_name": "M",
"credential": "DNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-05",
"last_updated": "2022-09-15",
"certification_date": "2022-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NC",
"license": "REYN-T5D62",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.