Individual provider Active NPI

Blair Harrison Reynolds

  • Student in an Organized Health Care Education/Training Program
  • Knoxville, TN
National Provider Identifier
1306209689
Registry record updated Jun 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1924 Alcoa Hwy
Knoxville, TN 37920-1511
Phone
(865) 305-9340
NPI assigned
Apr 3, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1924 Alcoa Hwy
Knoxville, TN 37920-1511

Mailing address

3436 Adams Gate Rd
Knoxville, TN 37931-2300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190814003864 TN Practitioner - Internal Medicine 3577859057

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Tennessee, HSC, College of Medicine, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

7725 W Reno Ave
Suite 150
Oklahoma City, OK 73127-9712

PO Box
Suite 207829
Dallas, TX 75320-0001

Hospital & facility affiliations

  • Fort Sanders Regional Medical Center Hospital, Knoxville, TN, CCN 440125
  • Patricia Neal Rehabilitation Hospital Inpatient rehabilitation facility, Knoxville, TN, CCN 443039

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Statcare Inpatient LLC CurrentSince Jul 15, 2019 Accepting new patients
Rehabilitation Hospital of Knox County, LLC Past Accepting new patients

Locations

1901 Clinch Ave
Knoxville, TN 37916
Phone (865) 331-1111

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1459641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466985600000",
    "number": "1306209689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3436 ADAMS GATE RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379312300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1924 ALCOA HWY",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379201511",
            "telephone_number": "865-305-9340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "BLAIR",
        "middle_name": "HARRISON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-03",
        "last_updated": "2016-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.