Philip Taylor Reynolds, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

15204 Issued in TX

Practice address

128 Nacogdoches St
Center, TX 75935-3852

Phone

(936) 427-9070

Fax

(936) 591-8191

NPI assigned

May 19, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dentist

Education

Other, 1986

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/148f5931-d9cf-4d65-8c66-7021ed161b73/

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.

• Poarch Band of Creek Indians

  dba Poarch Creek Indian Health Department

  • Federally Qualified Health Center (FQHC)
  • Atmore, AL
  • NPI 1902916489

  TX

  Medicare reassignment NPD
• JLS Dental PLLC

  • General Practice Dentistry
  • Center, TX
  • NPI 1871951541
  NPD (past)

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

{
    "created_epoch": "1211155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417651200000",
    "number": "1700043718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 NACOGDOCHES ST",
            "city": "CENTER",
            "state": "TX",
            "postal_code": "759353852",
            "telephone_number": "936-427-9070",
            "fax_number": "936-591-8191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 NACOGDOCHES ST",
            "city": "CENTER",
            "state": "TX",
            "postal_code": "759353852",
            "telephone_number": "936-427-9070",
            "fax_number": "936-591-8191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "PHILIP",
        "middle_name": "TAYLOR",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-19",
        "last_updated": "2014-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "15204",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "15204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Randell B. Cox OD PA
• Jill Ray
• Tori Lynn Rebollar
• Renal Care Group Texas, Inc. (RENAL CARE GROUP Woodlands)
• Monica Reyna, PA-C
• Julie M. Rholes, R.D.
• Robert Richardson, PHARM D
• Right Step Adult Day Care, LLC (Right Choice Adult Day Care)
• Right Step Adult Day Care, LLC (Right Step Wheeling Meals)
• Shawn G. Riley, D.C.

• General Practice Dentistry in Center, TX
• Providers in Center, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2014; 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.