Jeffrey A Reynolds, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

160 Issued in TN

Practice address

908 W 4TH North St
Morristown, TN 37814-3894

Phone

(423) 586-4231

Fax

(865) 291-3228

NPI assigned

Jun 12, 2006

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

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

Physician Assistant

Education

Other, 1985

Medicare assignment

May accept Medicare assignment

Group practices

Bradley Physician Services, LLCGroup PAC ID 8123563392, 77 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: jeffrey.reynolds.1@31613.direct.athenahealth.com
• Direct secure messaging: jeffrey.reynolds.1@1525.direct.athenahealth.com

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.

• Bradley Physician Services, LLC

  • Orthopaedic Surgery of the Spine Physician
  • Cleveland, TN
  • NPI 1710727540
  Medicare reassignment Care Compare group
• Emergency Coverage Services, PC

  • Nurse Practitioner
  • Lawrenceburg, TN
  • NPI 1053351593
  Medicare reassignment

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1508808577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1060 PEERLESS XING NW STE 200",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373123785",
            "telephone_number": "423-479-4165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "908 W 4TH NORTH ST",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378143894",
            "telephone_number": "423-586-4231",
            "fax_number": "865-291-3228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "JEFFREY",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4050526",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jeffrey.reynolds.1@1525.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR Direct Address",
            "address_1": "1060 Peerless Xing NW Ste 200",
            "city": "Cleveland",
            "state": "TN",
            "country_code": "US",
            "postal_code": "373123785",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Omer Clyde Renner Jr., MD
• Restorative Family Medicine
• Jennifer R. Revis, M.S.
• Madonna Reyes, PT
• Tonya M. Reyes, MSN, FNP
• Savannah Faye Reynolds, DC
• Michelle Lee Rice, LCSW
• Leslie Ann Rich, DNP, WHNP
• Logan Andrew Ricker, M.S. CCC-SLP
• Mariah Summer Ricker, DMD

• Physician Assistant in Morristown, TN
• Providers in Morristown, TN by specialty
• Physician Assistant in Tennessee

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