Active NPI
Tyler Shane Reynolds, MD
- Surgical Critical Care Physician
- Springfield, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Critical Care Physician
- License
- ME163370
- Practice address
- 3800 S National Ave Ste 605
Springfield, MO 65807-5209 - Phone
- (417) 875-3000
- NPI assigned
- Aug 28, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | A101986 | CA | |
| Surgery Physician | 208600000X | 2022007281 | MO | |
| Surgical Critical Care Physician | 2086S0102X | ME163370 | FL | Primary |
| Surgery Physician | 208600000X | 074569 | GA |
Addresses
Primary practice location
3800 S National Ave Ste 605
Springfield, MO 65807-5209
Mailing address
215 Katnack Rd
St Augustine, FL 32095-8352
Other practice location 1
3627 University Blvd S Ste 305
Jacksonville, FL 32216-4294
Phone (904) 593-0760
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200116135 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS, MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mercy Clinic Springfield Communities
Practice addresses (Care Compare)
1001 E Primrose
Springfield, MO 65807-5155
1001 E Primrose St
Springfield, MO 65807-5155
1965 S Fremont Ave
230 MC General and Trauma Surgery
Springfield, MO 65804-2258
Phone (417) 820-7250
3250 Gordonville Rd
Suite 384
Cape Girardeau, MO 63703-5095
Phone (573) 331-5522
3801 S National
Ferrell Duncan Clinic
Springfield, MO 65807-5210
Phone (417) 269-6000
3801 S National Ave
900 Neurology
Springfield, MO 65807-5210
Phone (417) 269-6000
Hospital & facility affiliations
- Saint Francis Medical Center
- Cox Medical Centers
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lester E Cox Medical Centers | Current | Accepting new patients | |
| Mercy Clinic Springfield Communities | Current | Accepting new patients | |
| Vicksburg Healthcare LLC | Current | Accepting new patients | |
| Mercy Clinic Springfield Communities | Current | Accepting new patients | |
| Lester E Cox Medical Centers | Current | Accepting new patients | |
| Saint Francis Medical Center | Current | Accepting new patients | |
| Lester E Cox Medical Centers | Current | Accepting new patients | |
| Mercy Clinic Springfield Communities | Current | Accepting new patients | |
| Vicksburg Healthcare LLC | Current | Accepting new patients | |
| Saint Francis Medical Center | Current | Accepting new patients | |
| Saint Francis Medical Center | Current | Accepting new patients | |
| Northwest Florida Multispecialty Physicians LLC | Past | Accepting new patients | |
| Emory Specialty Associates, LLC | Past | Accepting new patients |
Locations
3250 Gordonville Rd
Ste 384
Cape Girardeau, MO 63703
Phone (573) 331-5522
211 Saint Francis Dr
Cpe Girardeau, MO 63703
Phone (573) 331-3000
3250 Gordonville Rd
Ste 206
Cpe Girardeau, MO 63703
Phone (573) 331-4480
1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379
1965 S Fremont Ave
Ste 230
Springfield, MO 65804
Phone (417) 820-3809
2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905
1001 E Primrose St
Springfield, MO 65807
Phone (417) 875-3434
3800 S National Ave
Ste 600
Springfield, MO 65807
Phone (417) 269-1499
2100 Highway 61 N
Vicksburg, MS 39183
Phone (601) 883-5001
Interoperability endpoints
- treynolds112600@surescripts.sfmc.net
- tyler.reynolds@hca5.eclinicaldirectplus.com
- treynolds20265@direct.emory.org
Organizations & group practices 14
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.
-
- General Practice Physician
- Springfield, MO
- NPI 1760405864
-
- Anesthesiology Physician
- Cape Girardeau, MO
- NPI 1356304489
-
- Family Medicine Physician
- Springfield, MO
- NPI 1245277631
-
- Rural Health Clinic/Center
- Willow Springs, MO
- NPI 1972771657
-
- Anesthesiology Physician
- Vicksburg, MS
- NPI 1629084058
-
- Family Medicine Physician
- Shell Knob, MO
- NPI 1538334396
-
- Neurology Physician
- Springfield, MO
- NPI 1023763414
-
- Family Medicine Physician
- Springfield, MO
- NPI 1922126077
-
- Family Medicine Physician
- Hollister, MO
- NPI 1053350454
-
- Internal Medicine Physician
- Cape Girardeau, MO
- NPI 1578513016
-
- Clinic/Center
- Jackson, MO
- NPI 1992502975
-
- General Acute Care Hospital
- Vicksburg, MS
- NPI 1215981303
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Springfield, MO
- NPI 1093740128
-
- General Acute Care Hospital
- Cape Girardeau, MO
- NPI 1467412726
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788220800000",
"number": "1376737874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 KATNACK RD",
"city": "ST AUGUSTINE",
"state": "FL",
"postal_code": "320958352",
"fax_number": "678-737-1024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3800 S NATIONAL AVE STE 605",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658075209",
"telephone_number": "417-875-3000"
}
],
"practiceLocations": [
{
"address_1": "3627 University Blvd S Ste 305",
"address_purpose": "LOCATION",
"city": "Jacksonville",
"state": "FL",
"postal_code": "322164294",
"country_code": "US",
"telephone_number": "904-593-0760",
"fax_number": "904-398-1729",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "REYNOLDS",
"first_name": "TYLER",
"middle_name": "SHANE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-28",
"last_updated": "2026-09-01",
"certification_date": "2026-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CA",
"license": "A101986",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MO",
"license": "2022007281",
"primary": false
},
{
"code": "2086S0102X",
"taxonomy_group": "",
"desc": "Surgery, Surgical Critical Care",
"state": "FL",
"license": "ME163370",
"primary": true
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "GA",
"license": "074569",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200116135",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Springfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 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.