Individual provider Active NPI

Mark A Reynolds, MD

  • Surgery Physician
  • Florence, SC
National Provider Identifier
1659344810
Registry record updated Feb 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
19841 Issued in SC
Practice address
800 E Cheves St
Ste 260
Florence, SC 29506
Phone
(843) 665-7941
Fax
(843) 665-1257
NPI assigned
Feb 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Trauma Surgery Physician 2086S0127X 19841 SC
Surgery Physician 208600000X 19841 SC Primary

Addresses

Primary practice location

800 E Cheves St
Ste 260
Florence, SC 29506

Mailing address

PO Box 3239
Florence, SC 29502-3239
Phone (843) 665-7941

Other identifiers 2

IdentifierTypeStateIssuer
89063PKOtherNCNC MEDICAID
198413MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mark.reynolds@mpaii.eclinicaldirectplus.com Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061218000382 SC Practitioner - General SurgeryPractitioner - Vascular Surgery 3274532387 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Temple University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLeod Physician Associates IIGroup PAC ID 8224031307, 541 clinicians

Practice addresses (Care Compare)

555 E Cheves St
Florence, SC 29506-2617
Phone (843) 777-7000

800 E Cheves St
Florence, SC 29506-2650

800 E Cheves St
Florence, SC 29506-2652

Hospital & facility affiliations

  • McLeod Regional Medical Center-Pee Dee Hospital, Florence, SC, CCN 420051

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19841SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Physician Associates II Surgery CurrentSince Oct 1, 2006 Accepting new patients
McLeod Physician Associates II CurrentSince Oct 1, 2006 Accepting new patients
McLeod Regional Medical Center of the Pee Dee, Inc. Past Accepting new patients

Locations

800 E Cheves St
Ste 260
Florence, SC 29506
Phone (803) 665-7941

506 E Cheves St
#202
Florence, SC 29506

800 E Cheves St
Ste 480A
Florence, SC 29506
Phone (843) 777-7337

800 E Cheves St
Ste 240
Florence, SC 29506
Phone (843) 777-7950

Interoperability endpoints

  • Direct secure messaging: mark.reynolds@mpaii.eclinicaldirectplus.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
McLeod Home HealthFlorence, SC, CCN 427057 Home health agency Corporate Officer Jan 1, 2018

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613347200000",
    "number": "1659344810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3239",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295023239",
            "telephone_number": "843-665-7941",
            "fax_number": "843-665-1257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E CHEVES ST",
            "address_2": "STE 260",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "29506",
            "telephone_number": "843-665-7941",
            "fax_number": "843-665-1257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2021-02-15",
        "certification_date": "2021-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "SC",
            "license": "19841",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "19841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC MEDICAID",
            "identifier": "89063PK",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "198413",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mark.reynolds@mpaii.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "ECW DA",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EHR",
            "address_1": "800 E Cheves St",
            "address_2": "Ste 260",
            "city": "Florence",
            "state": "SC",
            "country_code": "US",
            "postal_code": "29506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Florence, SC

Sources for this page

Verify at the official NPI Registry.