Active NPI
William Reynolds, PA
- Physician Assistant
- Poinciana, FL
National Provider Identifier
1578598710
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA2007
- Practice address
- 105 N Doverplum Ave
Poinciana, FL 34758 - Phone
- (407) 943-8600
- Fax
- (407) 943-8625
- NPI assigned
- Jul 12, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA2007 | FL | Primary |
Addresses
Primary practice location
105 N Doverplum Ave
Poinciana, FL 34758
Mailing address
1050 Grape Ave
St Cloud, FL 34769
Phone (407) 343-2003
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA2007 | FL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| FL-I Medical Services LLC | Physician Assistant | Current | Accepting new patients |
| FL-I Medical Services, LLC | Physician Assistant | Current | Accepting new patients |
Locations
322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858
20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1578598710",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1050 GRAPE AVE",
"city": "ST CLOUD",
"state": "FL",
"postal_code": "34769",
"telephone_number": "407-343-2003",
"fax_number": "407-892-6468"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 N DOVERPLUM AVE",
"city": "POINCIANA",
"state": "FL",
"postal_code": "34758",
"telephone_number": "407-943-8600",
"fax_number": "407-943-8625"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOLDS",
"first_name": "WILLIAM",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA2007",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Poinciana, FL
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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.