Mikaela Renee Reynolds, WHCNP-BC

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

112193 Issued in NE

Practice address

3105 N 93Rd St
Omaha, NE 68134-4717

Phone

(877) 811-7526

Fax

(515) 280-9525

NPI assigned

Nov 16, 2020

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 names 1

• Mikaela Sandorst Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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.

• Pottawattamie County

  • Public Health or Welfare Agency
  • Council Bluffs, IA
  • NPI 1053881102
  NPD

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

{
    "created_epoch": "1605484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1497357255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "818 5TH AVE STE 200",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503091307",
            "telephone_number": "877-811-7526",
            "fax_number": "515-280-9525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3105 N 93RD ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681344717",
            "telephone_number": "877-811-7526",
            "fax_number": "515-280-9525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "MIKAELA",
        "middle_name": "RENEE",
        "credential": "WHCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-16",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NE",
            "license": "112193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIKAELA",
            "last_name": "SANDORST",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jamie Susanne Reynolds, PHARM.D.
• Karrie Reynolds, M.S., LMHP, CPC, NCC
• Mackenzie Reynolds, M.D.
• Mandy Lynn Reynolds
• Marie Ruth Reynolds, RN
• Nicole Marie Reynolds, MA, CCC-SLP
• Noah David Reynolds, DO
• Phoenix Dawn Reynolds
• Sarah Reynolds, PT
• Scott B. Reynolds, M.D.

• Women's Health Nurse Practitioner in Omaha, NE
• Providers in Omaha, NE by specialty
• Women's Health Nurse Practitioner in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2020; 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.