Individual provider Active NPI

Jenna Marie Reynolds, AU.D., CCC-A

  • Audiologist
  • East Lansing, MI
National Provider Identifier
1417846809
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
1601001218 Issued in MI
Practice address
1500 Abbot Rd Ste 400
East Lansing, MI 48823-1956
Phone
(517) 332-0100
NPI assigned
Jun 30, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 1601001218 MI Primary

Addresses

Primary practice location

1500 Abbot Rd Ste 400
East Lansing, MI 48823-1956

Mailing address

3637 Jolly Oak Rd Unit B2094
Okemos, MI 48864-2520
Phone (218) 590-8344

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250730000456 MI Practitioner - Qualified Audiologist 6406363860 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid Michigan Ear Nose and Throat PCGroup PAC ID 1052363801, 25 clinicians

Practice addresses (Care Compare)

1500 Abbott Rd
Suite 400
East Lansing, MI 48823-1956
Phone (517) 324-4911

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mid Michigan Ear Nose and Throat PC CurrentSince Jun 13, 2025 Accepting new patients
Mid Michigan Ear Nose & Throat, P.C. Audiologist PastSince Jun 13, 2025 Accepting new patients

Locations

1500 Abbott Rd
Ste 400
East Lansing, MI 48823
Phone (517) 324-4911

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1751241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1417846809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3637 JOLLY OAK RD UNIT B2094",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488642520",
            "telephone_number": "218-590-8344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 ABBOT RD STE 400",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488231956",
            "telephone_number": "517-332-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "JENNA",
        "middle_name": "MARIE",
        "credential": "AU.D., CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-30",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MI",
            "license": "1601001218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.