Individual provider Active NPI

Bruce Grahlmann Reynolds III, MD

  • Student in an Organized Health Care Education/Training Program
  • Tallahassee, FL
National Provider Identifier
1689421000
Registry record updated May 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
2600 Centennial PL Ste 200
Tallahassee, FL 32308-0583
Phone
(850) 431-5105
Fax
(850) 431-6727
NPI assigned
May 3, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

2600 Centennial PL Ste 200
Tallahassee, FL 32308-0583

Mailing address

2600 Centennial PL Ste 200
Tallahassee, FL 32308-0583
Phone (850) 431-5105

Other practice location 1

1401 Centerville Rd Ste 107
Tallahassee, FL 32308-4638
Phone (850) 431-5105

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240715004012 FL Order and Referring Only - PsychiatryPractitioner - Psychiatry 2163967001

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1714694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779235200000",
    "number": "1689421000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 CENTENNIAL PL STE 200",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323080583",
            "telephone_number": "850-431-5105",
            "fax_number": "850-431-6727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 CENTENNIAL PL STE 200",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323080583",
            "telephone_number": "850-431-5105",
            "fax_number": "850-431-6727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1401 Centerville Rd Ste 107",
            "address_purpose": "LOCATION",
            "city": "Tallahassee",
            "state": "FL",
            "postal_code": "323084638",
            "country_code": "US",
            "telephone_number": "850-431-5105",
            "fax_number": "850-431-6727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "BRUCE",
        "middle_name": "GRAHLMANN",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-03",
        "last_updated": "2026-05-20",
        "certification_date": "2026-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.