Jeffrey D Reynolds LLC

Primary specialty

Point of ServiceTaxonomy code 305S00000X

Legal business name

JEFFREY D REYNOLDS LLC

Practice address

16627 Pablo Island Drive
Groveland, FL 34736-9238

Phone

(352) 777-9887

NPI assigned

Sep 12, 2023

Organization subpart

No

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

Authorized official

Name

Jeffrey D Reynolds, LCSW

Title

Owner

Phone

(352) 777-9887

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jefferey David Reynolds, LCSW

  • Clinical Social Worker
  • West Palm Beach, FL
  • NPI 1962565812
  Medicare reassignment NPD

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

{
    "created_epoch": "1694476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694476800000",
    "number": "1376320531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16627 PABLO ISLAND DRIVE",
            "city": "GROVELAND",
            "state": "FL",
            "postal_code": "347369238",
            "telephone_number": "352-777-9887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16627 PABLO ISLAND DRIVE",
            "city": "GROVELAND",
            "state": "FL",
            "postal_code": "347369238",
            "telephone_number": "352-777-9887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY D REYNOLDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-12",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-777-9887",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tod Andre Howard, D.C.
• Shea Ann Humphrey, DO
• I Heart Home Care LLC
• Julie M. Jacobs-Higdon, RD / LDN
• Catalina Jamanca, PHARMD
• Jennifer Kaminski
• Devadah La Jeune King, APRN
• Janice Darden Krivan, ARNP
• Austin James Kry
• Savannah Lee Kuchenbaur

• Point of Service in Groveland, FL
• Providers in Groveland, FL by specialty
• Point of Service in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.