Bobby D Reynolds II

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

BOBBY D REYNOLDS II

Practice address

3010 Bristol Hwy
Johnson City, TN 37601-1512

Phone

(423) 282-4170

Fax

(423) 282-4903

NPI assigned

Oct 5, 2006

Last updated

Nov 16, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Bobby D Reynolds II, FNPNPI 1356455174

Title

Owner

Phone

(423) 282-4107

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Appalachian Medical Center Other name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bobby Dean Reynolds II, FNP

  • Family Nurse Practitioner
  • Elizabethton, TN
  • NPI 1356455174
  NPD (past) Authorized official

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195171200000",
    "number": "1306932470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3010 BRISTOL HWY",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011512",
            "telephone_number": "423-282-4170",
            "fax_number": "423-282-4903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3010 BRISTOL HWY",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011512",
            "telephone_number": "423-282-4170",
            "fax_number": "423-282-4903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOBBY D REYNOLDS II",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-11-16",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "BOBBY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-282-4107",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3700419",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Appalachian Medical Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Blue Ridge Physical Therapy, Inc.
• Patrick Holloway Blythe
• Leslie Bodo, FNP-BC
• Siegfried Hans Boehm
• Anna Bogart, LPC
• Teresa Lynn Boggs, M.S., CCC-SLP
• Charissa Bogle, LCSW

• Family Nurse Practitioner in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2007; 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.