Roger Reynolds, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DO18450 Issued in OR

Practice address

1825 Maple St
Forest Grove, OR 97116-1939

Phone

(503) 357-2136

NPI assigned

Aug 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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 and National Provider Directory roles.

• Tuality Medical Group LLC

  • Internal Medicine Physician
  • Hillsboro, OR
  • NPI 1073929782
  Medicare reassignment NPD
• Tuality Healthcare

  dba THC Based Physicians

  • General Acute Care Hospital
  • Hillsboro, OR
  • NPI 1336228659
  NPD
• Tuality Medical Group LLC

  dba Hillsboro Medical Center Neurology Clinic

  • Neurology Physician
  • Hillsboro, OR
  • NPI 1639690704
  NPD

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357776000000",
    "number": "1689682254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 MAPLE ST",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "971161939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 MAPLE ST",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "971161939",
            "telephone_number": "503-357-2136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "ROGER",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2013-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO18450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "56908",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• R L Goff Enterprises, Inc (Forest Grove Pharmacy LLC)
• John Wilfred Randall, OD, MPH
• Raven Song Counseling
• Lee Ann Remington, O.D.
• Restore Massage Therapy, Inc
• Richardson Eyecare PC
• Brad C Richardson, O.D.
• Eli Richardson, O.D.
• Jessica Richardson, AU.D.
• Levi Richardson, OD

• Family Medicine Physician in Forest Grove, OR
• Providers in Forest Grove, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.