Mitchell J Reynolds, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

9993 Issued in TN

Practice address

9430 Park West Blvd
Suite 230
Knoxville, TN 37923-4200

Phone

(865) 690-4861

NPI assigned

Jun 11, 2014

Sex

Male

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1402444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508803200000",
    "number": "1417361049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 32569",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379302569",
            "telephone_number": "865-694-0062",
            "fax_number": "865-694-7907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9430 PARK WEST BLVD",
            "address_2": "SUITE 230",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234200",
            "telephone_number": "865-690-4861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "MITCHELL",
        "middle_name": "J",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-11",
        "last_updated": "2017-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "9993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q007022",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Harold Reynolds, CPO
• John M Reynolds IV, MD
• Krista Alexia Reynolds
• Kristopher Reynolds
• Megan Nicole Reynolds
• Rhett Matthew Reynolds, LCSW
• Theresa Michal Reynolds
• Whitney Hubbs Reynolds, CPNP
• William Reynolds
• Michelle Reynoso, M.S., CCC-SLP

• Physical Therapist in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Physical Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.