Individual provider Active NPI

Joe L Reynolds, ANP

  • Adult Health Nurse Practitioner
  • Society Hill, SC
National Provider Identifier
1588335962
Registry record updated Aug 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
25420 Issued in SC
Practice address
737 S Main St
Society Hill, SC 29593-8972
Phone
(843) 378-4501
Fax
(843) 378-4209
NPI assigned
Sep 24, 2021
Last updated
Aug 26, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 25420 SC Primary

Addresses

Primary practice location

737 S Main St
Society Hill, SC 29593-8972

Mailing address

PO Box 1090
Hartsville, SC 29551-1090
Phone (843) 857-0111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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

Enrollment IDStateProvider typePAC IDDetails
I20211217000569 SC Practitioner - Nurse Practitioner 6103217658 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caresouth Carolina Inc.Group PAC ID 1052221314, 66 clinicians

Practice addresses (Care Compare)

545 Sumter Hwy
Bishopville, SC 29010-7601
Phone (803) 484-5317

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Caresouth Carolina, Inc. Current Accepting new patients
Caresouth Carolina, Inc CurrentSince Nov 30, 2021 Accepting new patients
Caresouth Carolina, Inc Past Accepting new patients

Locations

545 Sumter Hwy
Bishopville, SC 29010
Phone (803) 484-5317

1268 S 4th St
Hartsville, SC 29550
Phone (843) 332-3422

737 S Main St
Society Hill, SC 29593
Phone (843) 378-4501

Interoperability endpoints

  • Direct secure messaging: joe.reynolds@csci.eclinicaldirectplus.com

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1632441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661472000000",
    "number": "1588335962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1090",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295511090",
            "telephone_number": "843-857-0111",
            "fax_number": "843-857-0206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "737 S MAIN ST",
            "city": "SOCIETY HILL",
            "state": "SC",
            "postal_code": "295938972",
            "telephone_number": "843-378-4501",
            "fax_number": "843-378-4209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "JOE",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-24",
        "last_updated": "2022-08-26",
        "certification_date": "2022-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "SC",
            "license": "25420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Society Hill, SC

Sources for this page

Verify at the official NPI Registry.