Mark E. Reynolds, FNAP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

566392 Issued in TX

Practice address

3712 22ND St
Lubbock, TX 79410-1312

Phone

(806) 795-5561

Fax

(806) 793-9817

NPI assigned

Oct 31, 2005

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: mark.reynolds@direct.myteamcare.com

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214524800000",
    "number": "1629069422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3712 22ND ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101312",
            "telephone_number": "806-795-5561",
            "fax_number": "806-793-9817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3712 22ND ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101312",
            "telephone_number": "806-795-5561",
            "fax_number": "806-793-9817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "MARK",
        "middle_name": "E.",
        "name_prefix": "Mr.",
        "credential": "FNAP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2008-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "566392",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0074JY",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148066702",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charles A Reynolds, MD
• Jacob Reynolds, M.D.
• Jesse Duell Reynolds
• Kyle T Reynolds, D.D.S.
• Lisa Diane Reynolds
• Rex Hugh Reynolds, M.D.
• Gia Rhodes, RBT
• Rebecca Rhodes
• Sabra Rhodes, RBT
• Sarah Rhodes, LPC

• Family Nurse Practitioner in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; 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.