Individual provider Active NPI

Tina S. Reynolds, L.P.N.

  • Licensed Practical Nurse
  • Soddy Daisy, TN
National Provider Identifier
1528185188
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LPN0000032226 Issued in TN
Practice address
9527 W Ridge Trail Rd
Soddy Daisy, TN 37379-4018
Phone
(423) 842-3031
Fax
(423) 842-5353
NPI assigned
Mar 26, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LPN0000032226 TN Primary

Addresses

Primary practice location

9527 W Ridge Trail Rd
Soddy Daisy, TN 37379-4018

Mailing address

4744 Pine View LN
Chattanooga, TN 37416-1939
Phone (423) 893-1902

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPN0000032226TNMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528185188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4744 PINE VIEW LN",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374161939",
            "telephone_number": "423-893-1902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9527 W RIDGE TRAIL RD",
            "city": "SODDY DAISY",
            "state": "TN",
            "postal_code": "373794018",
            "telephone_number": "423-842-3031",
            "fax_number": "423-842-5353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "TINA",
        "middle_name": "S.",
        "credential": "L.P.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "TN",
            "license": "LPN0000032226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Soddy Daisy, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.