Active NPI
Kristen Reynolds
- Physical Therapist
- Garden City, NY
National Provider Identifier
1306692827
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 05203701
- Practice address
- 53 Magnolia Ave
Garden City, NY 11530-6223 - Phone
- (516) 655-3700
- NPI assigned
- Apr 25, 2024
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 05203701 | NY | Primary |
Addresses
Primary practice location
53 Magnolia Ave
Garden City, NY 11530-6223
Mailing address
53 Magnolia Ave
Garden City, NY 11530-6223
Phone (516) 655-3700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05203701 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1714003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714003200000",
"number": "1306692827",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "53 MAGNOLIA AVE",
"city": "GARDEN CITY",
"state": "NY",
"postal_code": "115306223",
"telephone_number": "516-655-3700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "53 MAGNOLIA AVE",
"city": "GARDEN CITY",
"state": "NY",
"postal_code": "115306223",
"telephone_number": "516-655-3700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOLDS",
"first_name": "KRISTEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-04-25",
"last_updated": "2024-04-25",
"certification_date": "2024-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "05203701",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Garden City, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.