Kim Aurora Reynolds Edwards, M.D

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

200301405 Issued in NC

Practice address

2305 Executive Cir
102
Greenville, NC 27834-3749

Phone

(252) 439-0700

Fax

(252) 439-0900

NPI assigned

Sep 26, 2006

Last updated

Mar 7, 2023By 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 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

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

Psychiatry

Education

Brody School of Medicine at East Carolina University, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Integrated Family Services PLLCGroup PAC ID 2567464563, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Integrated Family Services PLLC

  • Community/Behavioral Health Agency
  • Ahoskie, NC
  • NPI 1942289244
  Medicare reassignment Care Compare group NPD
• Integrated Family Services PLLC

  • Clinical Social Worker
  • Elizabeth City, NC
  • NPI 1629205208
  NPD
• Integrated Family Services

  • Community/Behavioral Health Agency
  • Greenville, NC
  • NPI 1487094124
  NPD (past)
• Integrated Family Services PLLC

  • Clinical Social Worker
  • Greenville, NC
  • NPI 1740451921
  NPD (past)

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1699876300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 885",
            "city": "AHOSKIE",
            "state": "NC",
            "postal_code": "279100885",
            "telephone_number": "252-439-0700",
            "fax_number": "252-439-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 EXECUTIVE CIR",
            "address_2": "102",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278343749",
            "telephone_number": "252-439-0700",
            "fax_number": "252-439-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS EDWARDS",
        "first_name": "KIM",
        "middle_name": "AURORA",
        "name_prefix": "Mrs.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2023-03-07",
        "certification_date": "2022-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NC",
            "license": "200301405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "200301405",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891350",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Edith Margarita Reyes Alvarado, M.D.
• John Edward Reynolds, M.D.
• Reuben Reynolds, MD
• Tammy Mickey Reynolds
• Jennifer Parks Rezeli, LPC, LCASA
• Rha Health Services NC LLC

• Child & Adolescent Psychiatry Physician in Greenville, NC
• Providers in Greenville, NC by specialty
• Child & Adolescent Psychiatry Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.