Individual provider Active NPI

Amanda Jean Reynolds, M.D.

  • Pediatrics Physician
  • Phoenix, AZ
National Provider Identifier
1588980700
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
47681 Issued in AZ
Practice address
2601 E Roosevelt St
Phoenix, AZ 85008-4973
Phone
(602) 344-5011
NPI assigned
Apr 13, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 47681 AZ
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 47681 AZ Primary

Addresses

Primary practice location

2601 E Roosevelt St
Phoenix, AZ 85008-4973

Mailing address

3200 E Camelback Rd Ste 250
Phoenix, AZ 85018-2327
Phone (602) 933-1814

Other practice location 1

1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone (602) 933-0777

Other practice location 2

3555 S Val Vista Dr
Gilbert, AZ 85297-7323
Phone (602) 933-0777

Other identifiers 1

IdentifierTypeStateIssuer
804216MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130531000020 AZ Practitioner - Pediatric MedicinePractitioner - Hospitalist 7719125889 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Children'S Medical Group CurrentSince Jun 1, 2013 Accepting new patients
District Medical Group, Inc CurrentSince Jun 1, 2025 Accepting new patients
District Medical Group, Inc Current Accepting new patients
Phoenix Children'S Hospital Pediatrics Current Accepting new patients
Phoenix Children'S Medical Group CurrentSince Jun 1, 2013 Accepting new patients
District Medical Group, Inc Pediatrics Past Accepting new patients

Locations

3555 S Val Vista Dr
Gilbert, AZ 85297
Phone (480) 434-4356

19007 N 67th Ave
Glendale, AZ 85308
Phone (602) 933-0777

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

3200 E Camelback Rd
Ste 250
Phoenix, AZ 85018
Phone (602) 933-1814

2525 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 344-1015

2929 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 470-5043

2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298

1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777

Interoperability endpoints

  • Direct secure messaging: areynolds22076@direct.mihs.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1271116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1588980700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 E CAMELBACK RD STE 250",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850182327",
            "telephone_number": "602-933-1814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 E ROOSEVELT ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850084973",
            "telephone_number": "602-344-5011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1919 E Thomas Rd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850167710",
            "country_code": "US",
            "telephone_number": "602-933-0777",
            "fax_number": "602-933-0755",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3555 S Val Vista Dr",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852977323",
            "country_code": "US",
            "telephone_number": "602-933-0777",
            "fax_number": "602-933-0755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "AMANDA",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-13",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AZ",
            "license": "47681",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "47681",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "804216",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.