Organization Active NPI

Reynoldson & Reynoldson Chrtd

  • Optometrist
  • Junction City, KS
National Provider Identifier
1417164534
Registry record updated Oct 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1107-3 Issued in KS
Legal business name
REYNOLDSON & REYNOLDSON CHRTD
Practice address
1208 W 8TH St
Junction City, KS 66441-2061
Phone
(785) 238-1104
Fax
(785) 238-2325
NPI assigned
May 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2012

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

Authorized official

Name
Dr. Guy M Reynoldson, O.D.NPI 1891726097
Title
Owner
Phone
(785) 238-1104

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1107-3 KS Primary

Addresses

Primary practice location

1208 W 8TH St
Junction City, KS 66441-2061

Mailing address

1208 W 8TH St
Junction City, KS 66441-2061
Phone (785) 238-1104

Other identifiers 2

IdentifierTypeStateIssuer
650865OtherKSBS SOLO
650542OtherKSBS GROUP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041228000675 KS Part B Supplier - Clinic/Group Practice 2466410154 Receives reassigned benefits from 1 practitioner
Practice locations: Junction City, KS

National Provider Directory

National Provider Directory

Locations

1208 W 8th St
Junction City, KS 66441
Phone (785) 238-1104

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349222400000",
    "number": "1417164534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1208 W 8TH ST",
            "city": "JUNCTION CITY",
            "state": "KS",
            "postal_code": "664412061",
            "telephone_number": "785-238-1104",
            "fax_number": "785-238-2325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 W 8TH ST",
            "city": "JUNCTION CITY",
            "state": "KS",
            "postal_code": "664412061",
            "telephone_number": "785-238-1104",
            "fax_number": "785-238-2325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REYNOLDSON & REYNOLDSON CHRTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2012-10-03",
        "status": "A",
        "authorized_official_last_name": "REYNOLDSON",
        "authorized_official_first_name": "GUY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "785-238-1104",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1107-3",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS SOLO",
            "identifier": "650865",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS GROUP",
            "identifier": "650542",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Junction City, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2012; 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.