Individual provider Active NPI

Carrie Anne Reynolds, MD

  • Pediatric Gastroenterology Physician
  • Phoenix, AZ
National Provider Identifier
1497985923
Registry record updated Dec 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
57505 Issued in AZ
Practice address
2601 E Roosevelt St
Phoenix, AZ 85008-4973
Phone
(602) 344-5011
Fax
(602) 344-5859
NPI assigned
Jul 17, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X 57505 AZ Primary
Pediatrics Physician 208000000X 57505 AZ

Addresses

Primary practice location

2601 E Roosevelt St
Phoenix, AZ 85008-4973

Mailing address

2929 E Thomas Rd
Phoenix, AZ 85016-8034
Phone (602) 470-5000

Other practice location 1

9224 Teddy Ln
Ste. 200
Lone Tree, CO 80124-6798
Phone (303) 790-1515

Other practice location 2

9300 Valley Childrens Pl # Se09
Madera, CA 93636-8761
Phone (559) 353-5745

Other identifiers 1

IdentifierTypeStateIssuer
1497985923MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, MI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240717002488 AZ Practitioner - Pediatric Medicine 0749531473 Reassigns benefits to 1 organization
I20240807004131 MI Practitioner - Pediatric MedicinePractitioner - Gastroenterology 0749531473 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
57505AZMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
District Medical Group, Inc CurrentSince Jun 3, 2024 Accepting new patients
District Medical Group, Inc CurrentSince Jun 3, 2024 Accepting new patients
Memorial Medical Center of West Michigan Pediatrics CurrentSince Apr 26, 2025 Accepting new patients
Spectrum Health United CurrentSince Apr 26, 2025 Accepting new patients
Mecosta County Medical Center Pediatrics CurrentSince Apr 26, 2025 Accepting new patients
District Medical Group, Inc Current Accepting new patients
Pennock Hospital CurrentSince Apr 26, 2025 Accepting new patients
Spectrum Health United CurrentSince Apr 26, 2025 Accepting new patients
Newaygo County General Hospital Association CurrentSince Apr 26, 2025 Accepting new patients
Memorial Medical Center of West Michigan CurrentSince Apr 26, 2025 Accepting new patients
Pennock Hospital CurrentSince Apr 26, 2025 Accepting new patients
Mecosta County Medical Center CurrentSince Apr 26, 2025 Accepting new patients
Mecosta County Medical Center Current Accepting new patients
Newaygo County General Hospital Association CurrentSince Apr 26, 2025 Accepting new patients
Healthone Clinic Services - Pediatric Specialties LLC Pediatrics Past Accepting new patients

Locations

8088 W Whitney Dr
Ste 2A
Peoria, AZ 85345
Phone (833) 855-9973

2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298

2525 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 344-1015

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

2929 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 470-5043

1227 W State St
Belding, MI 48809
Phone (616) 794-0800

605 Oak St
Big Rapids, MI 49307
Phone (231) 592-1079

212 S Sullivan Ave
Fremont, MI 49412
Phone (231) 924-1212

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

35 Michigan St NE
Ste 4150
Grand Rapids, MI 49503
Phone (616) 267-2100

1005 W Green St
Ste 300
Hastings, MI 49058
Phone (269) 948-8411

1 Atkinson Dr
Ludington, MI 49431
Phone (231) 843-2591

Interoperability endpoints

  • Direct secure messaging: creynolds17920@valleychildrens-prd.direct-ci.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/75620b41-1ac4-4c73-abd7-1415dc6810c3/

Organizations & group practices 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1247788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766361600000",
    "number": "1497985923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2929 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850168034",
            "telephone_number": "602-470-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 E ROOSEVELT ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850084973",
            "telephone_number": "602-344-5011",
            "fax_number": "602-344-5859"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9224 Teddy Ln",
            "address_2": "Ste. 200",
            "address_purpose": "LOCATION",
            "city": "Lone Tree",
            "state": "CO",
            "postal_code": "801246798",
            "country_code": "US",
            "telephone_number": "303-790-1515",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9300 Valley Childrens Pl # Se09",
            "address_purpose": "LOCATION",
            "city": "Madera",
            "state": "CA",
            "postal_code": "936368761",
            "country_code": "US",
            "telephone_number": "559-353-5745",
            "fax_number": "559-353-6093",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "CARRIE",
        "middle_name": "ANNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-17",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "AZ",
            "license": "57505",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "57505",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497985923",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.