Reynolds Plastic Surgery LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

107745 Issued in MO

Legal business name

REYNOLDS PLASTIC SURGERY LLC

Practice address

1531 E Bradford Pkwy
Suite 215
Springfield, MO 65804-6566

Phone

(417) 823-9777

Fax

(417) 823-9731

NPI assigned

Jun 20, 2008

Last updated

Nov 22, 2019By 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

Dr. William R Reynolds, M.D.NPI 1154416006

Title

Physician

Phone

(417) 823-9777

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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.

• William Robert Reynolds, M.D.

  • Specialist
  • Springfield, MO
  • NPI 1154416006
  Authorized official Same address or phone
• James Howard Swann, D.O.

  • Dermatology Physician
  • Springfield, MO
  • NPI 1225008881
  NPD (past)

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

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574380800000",
    "number": "1336300466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1531 E BRADFORD PKWY",
            "address_2": "SUITE 215",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658046566",
            "telephone_number": "417-823-9777",
            "fax_number": "417-823-9731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1531 E BRADFORD PKWY",
            "address_2": "SUITE 215",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658046566",
            "telephone_number": "417-823-9777",
            "fax_number": "417-823-9731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REYNOLDS PLASTIC SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-20",
        "last_updated": "2019-11-22",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "417-823-9777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MO",
            "license": "107745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201291408",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Frances Reuterfors, OT
• Michael Taylor Rexroad, M.S., GC
• Chan Ngo Reyes, MD
• Ciera Reyes
• Lirio Maxino Reyes, MD
• Emily B Reynolds
• Rhonda Reynolds
• Robert K Reynolds, D.D.S
• Taylor Reynolds, RBT
• Tyler Shane Reynolds, MD

• Specialist in Springfield, MO
• Providers in Springfield, MO by specialty
• Specialist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2019; 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.