Shane E Reynolds, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3491 Issued in AZ

Practice address

7615 W Thunderbird Rd
Ste 106
Peoria, AZ 85381-6083

Phone

(623) 773-2273

Fax

(623) 773-2274

NPI assigned

Oct 2, 2006

Last updated

Sep 9, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Banner Urgent Care Services LLCGroup PAC ID 4284921610, 207 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations (25 of 30)

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.

• Banner Urgent Care Services, LLC

  • Urgent Care Clinic/Center
  • Scottsdale, AZ
  • NPI 1609229764
  Medicare reassignment Care Compare group NPD (past)
• Banner Urgent Care Arizona LLC

  • Urgent Care Clinic/Center
  • Casa Grande, AZ
  • NPI 1316349855
  Medicare reassignment
• Banner Urgent Care Arizona LLC

  • Urgent Care Clinic/Center
  • Payson, AZ
  • NPI 1194369074
  NPD
• Banner Urgent Care Services, LLC

  • Urgent Care Clinic/Center
  • Tucson, AZ
  • NPI 1962855031
  NPD
• Tri-City Express Care, PLLC

  dba FastMed Urgent Care

  • Family Medicine Physician
  • Mesa, AZ
  • NPI 1649554940
  NPD
• Honorhealth Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Phoenix, AZ
  • NPI 1740273614
  NPD (past)
• Nextcare Arizona I JV LLC

  • Urgent Care Clinic/Center
  • Tempe, AZ
  • NPI 1114798071
  NPD (past)
• Sun Valley Urgent Care

  • Family Medicine Physician
  • Goodyear, AZ
  • NPI 1093858003
  NPD (past)
• Tri-City Express Care, PLLC

  dba FastMed Urgent Care

  • Urgent Care Clinic/Center
  • Phoenix, AZ
  • NPI 1376981092
  NPD (past)
• Tri-City Express Care, PLLC

  dba FastMed Urgent Care

  • Urgent Care Clinic/Center
  • Tempe, AZ
  • NPI 1477818730
  NPD (past)
• Tri-City Express Care, PLLC

  dba FastMed Urgent Care

  • Urgent Care Clinic/Center
  • Tucson, AZ
  • NPI 1710239082
  NPD (past)
• Tri-City Express Care, PLLC

  dba FastMed Urgent Care

  • Urgent Care Clinic/Center
  • Tolleson, AZ
  • NPI 1750728523
  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283990400000",
    "number": "1285727859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9609",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049159609",
            "telephone_number": "623-773-2273",
            "fax_number": "623-773-2274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7615 W THUNDERBIRD RD",
            "address_2": "STE 106",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853816083",
            "telephone_number": "623-773-2273",
            "fax_number": "623-773-2274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "SHANE",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2010-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "3491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "173336",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Resilient Solutions Counseling and Consulting Services LLC
• Reunion Rehabilitation Hospital Peoria, LLC (Rehabilitation Hospital Peoria)
• Janis S Rey
• Justin A Reynolds, MD
• Kaitlyn Reynolds, PT, DPT
• Rhad Academy and Healthcare
• Rhad Health Care
• Rhad Health Care LLC
• Vanessa Gail Rhodes, NP
• Bradley D Rice Jr., M.S. CCC-SLP

• Physician Assistant in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2010; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.