Individual provider Active NPI

Robert Chadd Reynolds

  • Ocularist
  • Waddell, AZ
National Provider Identifier
1689189656
Registry record updated Dec 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OcularistTaxonomy code 156FX1700X
Practice address
17740 W Stella LN
Waddell, AZ 85355-9640
Phone
(702) 824-5765
NPI assigned
Dec 12, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ocularist 156FX1700X Primary

Addresses

Primary practice location

17740 W Stella LN
Waddell, AZ 85355-9640

Mailing address

17740 W Stella LN
Waddell, AZ 85355-9640

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1513036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513036800000",
    "number": "1689189656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17740 W STELLA LN",
            "city": "WADDELL",
            "state": "AZ",
            "postal_code": "853559640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17740 W STELLA LN",
            "city": "WADDELL",
            "state": "AZ",
            "postal_code": "853559640",
            "telephone_number": "702-824-5765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "ROBERT",
        "middle_name": "CHADD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-12-12",
        "last_updated": "2017-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1700X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Ocularist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waddell, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2017; 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.