Ashley Reynolds, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA00650 Issued in MS

Practice address

4316 Old Canton Rd
Jackson, MS 39211-5995

Phone

(601) 543-2712

NPI assigned

Apr 14, 2022

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 identifiers 2

Medicare fee-for-service enrollment

Enrolled in MS

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Forrest County General HospitalGroup PAC ID 1052397767, 107 clinicians

FGH Trauma Surgery ClinicGroup PAC ID 7517916331, 20 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Forrest General Hospital Hospital, Hattiesburg, MS, CCN 250078

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• FGH Trauma Surgery Clinic

  • Surgery Physician
  • Hattiesburg, MS
  • NPI 1427090398
  Medicare reassignment Care Compare group
• Forrest County General Hospital

  • Psychiatric Hospital Unit
  • Hattiesburg, MS
  • NPI 1295837631
  Medicare reassignment Care Compare group
• Relias Clinical Decision Specialists of Hattiesburg, LLC

  • Emergency Medicine Physician
  • Hattiesburg, MS
  • NPI 1336867415
  Medicare reassignment NPD
• Relias Emergency Medicine Specialists of Hattiesburg LLC

  • Emergency Medicine Physician
  • Hattiesburg, MS
  • NPI 1609409440
  Medicare reassignment NPD
• FGH Physician Billing

  • Cardiovascular Disease Physician
  • Hattiesburg, MS
  • NPI 1053469700
  Medicare reassignment
• Relias Emergency Medicine Specialists of St Dominic LLC

  • Emergency Medicine Physician
  • Jackson, MS
  • NPI 1235808122
  Medicare reassignment
• Forrest County General Hospital

  dba Highland Center for Women's Health RHC

  • Rural Health Clinic/Center
  • Picayune, MS
  • NPI 1043820426
  NPD
• Forrest County General Hospital

  dba Jefferson Davis Rural Health Clinic

  • Rural Health Clinic/Center
  • Prentiss, MS
  • NPI 1689952707
  NPD
• Forrest County General Hospital

  • General Acute Care Hospital
  • Hattiesburg, MS
  • NPI 1225041809
  NPD (past)

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

• Forrest County General Hospital

  • General Acute Care Hospital
  • Hattiesburg, MS
  • NPI 1225041809
  Care Compare affiliation

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

{
    "created_epoch": "1649894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649894400000",
    "number": "1538802038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4316 OLD CANTON RD",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392115995",
            "telephone_number": "601-543-2712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4316 OLD CANTON RD",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392115995",
            "telephone_number": "601-543-2712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "ASHLEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-14",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MS",
            "license": "PA00650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSISSIPPI BOARD OF MEDICAL LICENSURE",
            "identifier": "PA00650",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TENNESSEE BOARD OF MEDICINE",
            "identifier": "4890",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hazan Retana, BA, PSYCHOLOGY
• Robert Kennedy Revere, DDS
• Jonathan Reves, D.O.
• Lindsay Elizabeth Rexrode, MD
• Roberto Rey Dios, M.D.
• Elizabeth R Reynolds
• Jada Reynolds, PCMHT
• Kayla Bonds Reynolds
• Rebecca Lee Reynolds, COTA/L
• Leila Rezaian-Yazdi, MD

• Physician Assistant in Jackson, MS
• Providers in Jackson, MS by specialty
• Physician Assistant in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.