Individual provider Active NPI

Ronald K Reynolds, M.D.

  • Emergency Medicine Physician
  • North Myrtle Beach, SC
National Provider Identifier
1376641878
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
13024 Issued in SC
Practice address
1714 Highway 17 S
North Myrtle Beach, SC 29582-4041
Phone
(843) 361-0705
Fax
(843) 361-4045
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 13024 SC Primary
Family Medicine Physician 207Q00000X 13024 SC

Addresses

Primary practice location

1714 Highway 17 S
North Myrtle Beach, SC 29582-4041

Mailing address

4416 Forest Dr
2ND Floor
Columbia, SC 29206-3104
Phone (803) 782-4278

Other identifiers 1

IdentifierTypeStateIssuer
130245MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070112000246 SC Practitioner - Emergency MedicinePractitioner - General Practice 7911989983

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
13024SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Progressive Physical Therapy, P.a. PastSince Sep 4, 2023 Accepting new patients
Emergency Medicine Specialists, P.C. Emergency Medicine Past Accepting new patients
Emergency Medicine Physicians of Brooke County, PLLC Emergency Medicine Past Accepting new patients
Doctors Care, PA Emergency Medicine Past Accepting new patients
Progressive Phyiscal Therapy, PA Past Accepting new patients

Organizations & group practices 5

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1376641878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4416 FOREST DR",
            "address_2": "2ND FLOOR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292063104",
            "telephone_number": "803-782-4278",
            "fax_number": "803-782-3445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1714 HIGHWAY 17 S",
            "city": "NORTH MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295824041",
            "telephone_number": "843-361-0705",
            "fax_number": "843-361-4045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "RONALD",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "13024",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "13024",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130245",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.