Terry Reynolds, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA3597 Issued in FL

Practice address

3000 Coral Hills Dr
Phoenix Emergency Medicine of Broward, LLC
Coral Springs, FL 33065-4108

Phone

(954) 344-3000

NPI assigned

Oct 15, 2005

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• The Olive Tree Wellness Center

  • Child & Adolescent Psychiatry Physician
  • Fort Mill, SC
  • NPI 1588899314
  NPD (past)
• Wake Forest University Health Sciences

  • Clinic/Center
  • Greensboro, NC
  • NPI 1194964379
  NPD (past)

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

{
    "created_epoch": "1129334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357171200000",
    "number": "1295724920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5028 NW 123RD AVE",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330763442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 CORAL HILLS DR",
            "address_2": "PHOENIX EMERGENCY MEDICINE OF BROWARD, LLC",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330654108",
            "telephone_number": "954-344-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "TERRY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-15",
        "last_updated": "2013-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA3597",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-03520",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "291118300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE CORE",
            "identifier": "E3618",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Revenue Cycle Corporate Group, Inc
• Donna Revera, OTR/L
• Marcela Reyes, LMT
• Maria L Reyes, P.T.
• Dwight C Reynolds, M.D.
• Yuval Reznik
• Rfa Medical Supplies LLC
• Rfa Partners, LLC
• RGB Medical Equipment LLC
• Damon Donnell Rhodes

• Physician Assistant in Coral Springs, FL
• Providers in Coral Springs, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 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.

Verify at the official NPI Registry.