Individual provider Active NPI

Chinika Rene Reynolds, PA-C

  • Physician Assistant
  • Denver, CO
National Provider Identifier
1336458702
Registry record updated Mar 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4409 Issued in CO
Practice address
1400 Jackson St
Denver, CO 80206-2762
Phone
(303) 388-4461
Fax
(303) 270-2206
NPI assigned
Oct 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0010-02536 NC
Physician Assistant 363A00000X 4409 CO Primary

Addresses

Primary practice location

1400 Jackson St
Denver, CO 80206-2762

Mailing address

1400 Jackson St
Denver, CO 80206-2761
Phone (303) 388-4461

Other identifiers 1

IdentifierTypeStateIssuer
09430253MedicaidCO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address NJHealth@njc.allscriptsdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160215002162 CO Practitioner - Physician Assistant 6800089962

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.78 of 100Reported as group
Quality
69.37
Promoting interoperability
100
Improvement activities
40
Cost
65.17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4409COMDMassage Therapist
0010-02536NCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Denver Health and Hospital Authority CurrentSince Jan 25, 2018 Accepting new patients

Locations

777 Bannock St
Denver, CO 80204

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1285891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1336458702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 JACKSON ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802062761",
            "telephone_number": "303-388-4461",
            "fax_number": "303-398-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 JACKSON ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802062762",
            "telephone_number": "303-388-4461",
            "fax_number": "303-270-2206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "CHINIKA",
        "middle_name": "RENE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-01",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-02536",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "4409",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09430253",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "NJHealth@njc.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "1400 Jackson St",
            "city": "Denver",
            "state": "CO",
            "country_code": "US",
            "postal_code": "802062762",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.