NPIMap

Individual provider Active NPI

Nicholas Thomas Reynolds, D.O.

  • Emergency Medicine Physician
  • Pagosa Springs, CO
National Provider Identifier
1679695548
Registry record updated Feb 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
DR.0057553 Issued in CO
Practice address
95 S Pagosa Blvd
Pagosa Springs, CO 81147-8329
Phone
(970) 731-3700
Fax
(970) 731-3707
NPI assigned
Apr 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4492 OK
Family Medicine Physician 207Q00000X DR.0057553 CO
Emergency Medicine Physician 207P00000X DR.0057553 CO Primary

Addresses

Primary practice location

95 S Pagosa Blvd
Pagosa Springs, CO 81147-8329

Mailing address

95 S Pagosa Blvd
Pagosa Springs, CO 81147-8329
Phone (970) 731-3700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, SD2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160322001642 TX Practitioner - Family Practice 4587758206 Reassigns benefits to 1 organization
I20241028002141 SD Practitioner - Emergency Medicine 4587758206 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Monument Health Network IncGroup PAC ID 5991616427, 163 clinicians

Practice addresses (Care Compare)

1440 N Main St
Spearfish, SD 57783-1505
Phone (605) 644-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.74 of 100Reported as group
Quality
92.26
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
85.41 of 100Reported as group
Quality
70.25
Promoting interoperability
100
Improvement activities
40
Cost
67.83

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0057553COMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Choctaw Nation of Oklahoma Current Accepting new patients
Choctaw Nation of Oklahoma CurrentSince Feb 3, 2016 Accepting new patients
Monument Health Network, Inc. Emergency Medicine CurrentSince Oct 1, 2024 Accepting new patients
Monument Health Network, Inc. CurrentSince Oct 1, 2024 Accepting new patients
Choctaw Nation of Oklahoma CurrentSince Feb 3, 2016 Accepting new patients
Monument Health Network, Inc. Current Accepting new patients
Wichita Emergency Physicians Emergency Medicine Past Accepting new patients

Locations

1585 W Liberty Rd
Atoka, OK 74525
Phone (580) 889-1981

1127 S George Nigh Expy
McAlester, OK 74501
Phone (800) 349-7026

1 Choctaw Way
Talihina, OK 74571
Phone (918) 423-8440

1440 N Main St
Spearfish, SD 57783
Phone (605) 644-4000

1420 N 10th St
Spearfish, SD 57783
Phone (605) 642-8414

Interoperability endpoints

  • Direct secure messaging: nreynolds.175542@regionalhealth.sdhealthlink.net

Organizations & group practices 7

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 7

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": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487203200000",
    "number": "1679695548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 S PAGOSA BLVD",
            "city": "PAGOSA SPRINGS",
            "state": "CO",
            "postal_code": "811478329",
            "telephone_number": "970-731-3700",
            "fax_number": "970-731-3707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 S PAGOSA BLVD",
            "city": "PAGOSA SPRINGS",
            "state": "CO",
            "postal_code": "811478329",
            "telephone_number": "970-731-3700",
            "fax_number": "970-731-3707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "NICHOLAS",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-04",
        "last_updated": "2017-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "4492",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0057553",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CO",
            "license": "DR.0057553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pagosa Springs, CO

Sources for this page

Verify at the official NPI Registry.