Jessica Lee Reynolds, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT002538 Issued in GA

Practice address

3575 Durden Dr NE Ste 303
Brookhaven, GA 30319-2255

Phone

(770) 515-9393

NPI assigned

Jul 27, 2009

Sex

Female

Sole proprietor

Yes

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

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Brookleigh Family Eyecare, Inc

  • Optometrist
  • Brookhaven, GA
  • NPI 1962955153
  Medicare reassignment NPD
• Saint Joseph'S Mercy Care Services Inc

  • Federally Qualified Health Center (FQHC)
  • Atlanta, GA
  • NPI 1588663421
  Medicare reassignment NPD
• Saint Joseph'S Mercy Care Services Inc

  • Federally Qualified Health Center (FQHC)
  • Atlanta, GA
  • NPI 1831266618
  NPD
• Saint Joseph'S Mercy Care Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Atlanta, GA
  • NPI 1285277608
  NPD
• Saint Joseph'S Mercy Care Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Atlanta, GA
  • NPI 1689921306
  NPD
• Saint Joseph'S Mercy Care Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Atlanta, GA
  • NPI 1821239708
  NPD

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

{
    "created_epoch": "1248652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633046400000",
    "number": "1295966174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3575 DURDEN DR NE STE 303",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303192255",
            "telephone_number": "770-515-9393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3575 DURDEN DR NE STE 303",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303192255",
            "telephone_number": "770-515-9393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "JESSICA",
        "middle_name": "LEE",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-27",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003574A",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rare Disease Research, LLC
• Dwarka Rathi, MD
• Radina Raytcheva
• Kendal Teresa Reeves, OTR/L
• Kishauna Reid
• Stephanie Reynolds
• Jeffrey M. Reznik, M.D.
• Ride Care
• Sarah Elise Riebel, APRN, CPNP-CP
• Mikayla Noel Ries, BS

• Optometrist in Brookhaven, GA
• Providers in Brookhaven, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2021; 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.

Verify at the official NPI Registry.