Michelle Reynolds, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

240 Willow St
Tyler, MN 56178-1201

Phone

(507) 247-5521

NPI assigned

Apr 12, 2017

Last updated

Oct 2, 2020By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Family Practice

Education

West Virginia University School of Medicine, 2017

Medicare assignment

May accept Medicare assignment

Group practices

Avera TylerGroup PAC ID 9638088537, 15 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Avera Tyler Hospital Hospital, Tyler, MN, CCN 241348
• Avera Marshall Regional Medical Ctr Hospital, Marshall, MN, CCN 241359

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Avera Tyler

  dba Avera Tyler Hospital

  • Critical Access Hospital
  • Tyler, MN
  • NPI 1801840517
  Medicare reassignment Care Compare group NPD
• Avera Marshall

  dba Avera Marshall Regional Medical Center

  • Critical Access Hospital
  • Marshall, MN
  • NPI 1568401016
  Medicare reassignment NPD
• Avera Marshall

  dba Avera Medical Group Optometry - Marshall

  • Optometrist
  • Marshall, MN
  • NPI 1487422465
  NPD
• Avera Marshall

  dba Avera Curaquick

  • Community Health Clinic/Center
  • Marshall, MN
  • NPI 1912265059
  NPD
• Avera Tyler

  dba Avera Medical Group Ivanhoe

  • Rural Health Clinic/Center
  • Ivanhoe, MN
  • NPI 1063949089
  NPD

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

• Avera Marshall

  dba Avera Marshall Regional Medical Center

  • Critical Access Hospital
  • Marshall, MN
  • NPI 1568401016
  Care Compare affiliation
• Avera Tyler

  dba Avera Tyler Hospital

  • Critical Access Hospital
  • Tyler, MN
  • NPI 1801840517
  Care Compare affiliation

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

{
    "created_epoch": "1491955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601596800000",
    "number": "1669906053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 WILLOW ST",
            "city": "TYLER",
            "state": "MN",
            "postal_code": "561781201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 WILLOW ST",
            "city": "TYLER",
            "state": "MN",
            "postal_code": "561781201",
            "telephone_number": "507-247-5521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "MICHELLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-12",
        "last_updated": "2020-10-02",
        "certification_date": "2020-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "68255",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lyon-Lincoln Electric Cooperative, Inc.
• Edward B Novak, MD
• Enrico Ocampo, M.D., FACP, FACE
• Amy Lea Reese, RN
• Christopher Stephen Reynolds, M.D.
• Southwest Family Chiropractic P.L.C.
• Thrifty Drug Stores Inc (Thrifty White Pharmacy #768)
• Tyler Family Dental PLLC
• Tyler Healthcare Center Dba Tyler Healthcare Pharmacy
• Marissa Rae Tyler, DC

• Student in an Organized Health Care Education/Training Program in Tyler, MN
• Providers in Tyler, MN by specialty
• Student in an Organized Health Care Education/Training Program in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.