Individual provider Active NPI

Tyler Shane Reynolds, MD

  • Surgical Critical Care Physician
  • Springfield, MO
National Provider Identifier
1376737874
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
ME163370 Issued in FL
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

Updated by the provider on Sep 1, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
200116135MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220613001650 MS Practitioner - General Surgery 6204977309 Reassigns benefits to 1 organization
I20221022000123 MO Practitioner - General Surgery 6204977309 Reassigns benefits to 5 organizations

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
Lester E Cox Medical CentersGroup PAC ID 8628092897, 243 clinicians
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians
Saint Francis Medical CenterGroup PAC ID 9931007929, 441 clinicians

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 Hospital, Cape Girardeau, MO, CCN 260183
  • Cox Medical Centers Hospital, Springfield, MO, CCN 260040

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lester E Cox Medical Centers CurrentSince Nov 21, 2022 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Oct 16, 2023 Accepting new patients
Vicksburg Healthcare LLC CurrentSince Apr 8, 2022 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Oct 16, 2023 Accepting new patients
Lester E Cox Medical Centers CurrentSince Mar 1, 2026 Accepting new patients
Saint Francis Medical Center Current Accepting new patients
Lester E Cox Medical Centers CurrentSince Mar 1, 2026 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Oct 16, 2023 Accepting new patients
Vicksburg Healthcare LLC CurrentSince Apr 8, 2022 Accepting new patients
Saint Francis Medical Center CurrentSince May 13, 2025 Accepting new patients
Saint Francis Medical Center CurrentSince May 13, 2025 Accepting new patients
Northwest Florida Multispecialty Physicians LLC PastSince Sep 8, 2021 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

  • Direct secure messaging: treynolds112600@surescripts.sfmc.net
  • Direct secure messaging: tyler.reynolds@hca5.eclinicaldirectplus.com
  • Direct secure messaging: 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.

View all 14

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

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

Verify at the official NPI Registry.