Miriam Reyna, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

650 Joel Dr
Fort Campbell, KY 42223-5318

Phone

(270) 798-4677

NPI assigned

Mar 22, 2021

Last updated

Mar 1, 2023By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1588240311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 JOEL DR",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 JOEL DR",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235318",
            "telephone_number": "270-798-4677"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5005 N. PIEDRAS STREET",
            "address_2": "William Beaumont Army Medical Center (WBAMC)",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "79920",
            "country_code": "US",
            "telephone_number": "915-742-2973",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Mendoza Soldier Family Care Center",
            "address_2": "11335 Ssg Sims St",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "79918",
            "country_code": "US",
            "telephone_number": "915-742-1259",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYNA",
        "first_name": "MIRIAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-22",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trevor James Reitz
• Sandra W Renfro, LCSW, CADC
• Nicholas Rensing, M.D.
• Lauren M Repak, PA-C
• Christine Reuscher, RN
• Morgan Reynolds, DO
• Anthony E Rhea
• Kristina Marie Rice, LCSW
• Trevor Ryan Rice, LMSW
• Katie L Richardson, PHARMD, BCOP

• Physician Assistant in Fort Campbell, KY
• Providers in Fort Campbell, KY by specialty
• Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2023; 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.