Robert David Reynolds Jr., APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

22665 Issued in TN

Practice address

1 Medical Park Blvd Ste 255W
Bristol, TN 37620-7430

Phone

(423) 844-5560

NPI assigned

Jun 3, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

State of Franklin Healthcare Associates, PLLCGroup PAC ID 2466346291, 258 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellmont Bristol Regional Medical Center Hospital, Bristol, TN, CCN 440012
• Johnson City Medical Center Hospital, Johnson City, TN, CCN 440063
• Johnston Memorial Hospital Hospital, Abingdon, VA, CCN 490053

Medicare enrollment (NPD)

Enrolled

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.

• State of Franklin Healthcare Associates PLLC

  • Internal Medicine Physician
  • Johnson City, TN
  • NPI 1063459410
  Medicare reassignment Care Compare group
• Medical Education Assistance Corporation

  • Internal Medicine Physician
  • Johnson City, TN
  • NPI 1235180480
  Medicare reassignment NPD
• Blue Ridge Medical Management Corporation

  • Urgent Care Clinic/Center
  • Elizabethton, TN
  • NPI 1144380833
  NPD
• Wellmont Health System

  • General Acute Care Hospital
  • Kingsport, TN
  • NPI 1760405849
  NPD
• Wellmont Medical Associates Inc

  • Family Medicine Physician
  • Big Stone Gap, VA
  • NPI 1174808216
  NPD (past)

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

• Mountain States Health Alliance

  • Psychiatric Hospital Unit
  • Johnson City, TN
  • NPI 1023434339
  Care Compare affiliation
• Mountain States Health Alliance

  • Psychiatric Hospital Unit
  • Johnson City, TN
  • NPI 1962915652
  Care Compare affiliation
• Mountain States Health Alliance

  • General Acute Care Hospital
  • Johnson City, TN
  • NPI 1972606465
  Care Compare affiliation
• Wellmont Health System

  • General Acute Care Hospital
  • Bristol, TN
  • NPI 1124058615
  Care Compare affiliation
• Johnston Memorial Hospital, Inc

  • General Acute Care Hospital
  • Abingdon, VA
  • NPI 1104812684
  Care Compare affiliation

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

{
    "created_epoch": "1496448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1497283402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 MED TECH PKWY STE 100",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042579",
            "telephone_number": "423-302-6567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PARK BLVD STE 255W",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376207430",
            "telephone_number": "423-844-5560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "557 Hickory Rd",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "TN",
            "postal_code": "376206059",
            "country_code": "US",
            "telephone_number": "276-696-5152",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 Med Tech Pkwy Ste 240",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376042641",
            "country_code": "US",
            "telephone_number": "423-794-5520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "ROBERT",
        "middle_name": "DAVID",
        "name_suffix": "Jr.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-03",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "22665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rreynolds17369@balladhealth.medalliesdirect.net",
            "affiliation": "Y",
            "endpointDescription": "Ballad Health Care Everywhere",
            "affiliationName": "Wellmont Medical Associates Inc",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "301 Med Tech Pkwy Ste 240",
            "city": "Johnson City",
            "state": "TN",
            "country_code": "US",
            "postal_code": "376042641",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Donald Smith Redford, D.D.S.
• Annette Sandra Reece, LBA, BCBA
• Renaissance Surgery Center, LLC
• Michael Wayne Rentz, MD
• Inger L Reynolds, CRNA
• Robert Scott Reynolds, PT, ATC
• C'Je Slagle Rhea, PHARMD
• Jared Lee Rhinehardt, MD
• Harlow M Rhudy, LCSW
• Sarah Alice Rhymer, MED

• Family Nurse Practitioner in Bristol, TN
• Providers in Bristol, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2022; 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.
• 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.