Michael Bruce Reynolds, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

10035532 Issued in OR

Practice address

36 SW Nye St
Newport, OR 97365-3821

Phone

(541) 265-4947

NPI assigned

Dec 19, 2022

Last updated

Jun 1, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA, OR2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

County of LincolnGroup PAC ID 3375439862, 28 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• County of Lincoln

  dba Coastal Healthcare

  • Federally Qualified Health Center (FQHC)
  • Newport, OR
  • NPI 1992755664
  Medicare reassignment Care Compare group NPD
• Desert Medical Group, Inc.

  dba Desert Oasis Healthcare Medical Group

  • Family Medicine Physician
  • Palm Springs, CA
  • NPI 1114918612
  Medicare reassignment NPD
• Thriveworks Clinical - California PC

  • Mental Health Counselor
  • Thousand Oaks, CA
  • NPI 1801481395
  Medicare reassignment NPD
• County of Lincoln

  dba Lincoln County Behavioral Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Newport, OR
  • NPI 1740061878
  NPD
• County of Lincoln

  dba Office Based Addiction Treatment (OBAT)

  • Clinic/Center
  • Newport, OR
  • NPI 1013626233
  NPD (past)
• County of Lincoln

  • Federally Qualified Health Center (FQHC)
  • Newport, OR
  • NPI 1982939641
  NPD (past)

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

{
    "created_epoch": "1671408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1346952603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 SW NYE ST",
            "city": "NEWPORT",
            "state": "OR",
            "postal_code": "973653821",
            "telephone_number": "541-265-0445",
            "fax_number": "844-760-0526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 SW NYE ST",
            "city": "NEWPORT",
            "state": "OR",
            "postal_code": "973653821",
            "telephone_number": "541-265-4947"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1105 SE Jetty Ave Ste C",
            "address_purpose": "LOCATION",
            "city": "Lincoln City",
            "state": "OR",
            "postal_code": "973672604",
            "country_code": "US",
            "telephone_number": "541-265-4947",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "525 N Bay St",
            "address_purpose": "LOCATION",
            "city": "Waldport",
            "state": "OR",
            "postal_code": "973949010",
            "country_code": "US",
            "telephone_number": "541-265-4947",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3531 Melody Ln",
            "address_purpose": "LOCATION",
            "city": "Palm Springs",
            "state": "CA",
            "postal_code": "922620402",
            "country_code": "US",
            "telephone_number": "132-380-4869",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2108 N St Ste N",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958165712",
            "country_code": "US",
            "telephone_number": "971-202-1820",
            "fax_number": "844-760-0526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "MICHAEL",
        "middle_name": "BRUCE",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-12-19",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "10035532",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95025779",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95025779",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500852591",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Newport, OR
• Providers in Newport, OR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.