Gracie Donnice Tad McReynolds, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

L6522 Issued in TX

Practice address

1201 W 38TH St
Austin, TX 78705-1006

Phone

(512) 324-1010

NPI assigned

Jun 16, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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 and National Provider Directory roles.

• Travis County Emergency Physicians PA

  • Emergency Medicine Physician
  • Austin, TX
  • NPI 1962440933
  Medicare reassignment NPD
• Third Coast Emergency Physicians Southwest PA

  • Emergency Medicine Physician
  • San Antonio, TX
  • NPI 1497793475
  Medicare reassignment
• Brazos Valley Emergency Physicians PA

  • Emergency Medicine Physician
  • Navasota, TX
  • NPI 1982642955
  NPD (past)

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225238400000",
    "number": "1396789582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3405 CACTUS WREN WAY",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787466636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 W 38TH ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787051006",
            "telephone_number": "512-324-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCREYNOLDS",
        "first_name": "GRACIE",
        "middle_name": "DONNICE TAD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2008-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "L6522",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158907901",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158907903",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158761004",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158761001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah McQueen, OTR
• Crystal McQueeney, LMT
• Leslie T McQuiston, MD
• Jacob Cain McRae
• Leah G McRee-Krim
• Katherine Carey McRoberts, SPEECH-LANGUAGE PATH
• Roger Lowell McRoberts III, MD
• Maureen Beiter McShane, RPH
• Alexandria Lee McStay, MA, CCC-SLP
• Micha D McVey-Leach, CRNA

• Emergency Medicine Physician in Austin, TX
• Providers in Austin, TX by specialty
• Emergency Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.