Individual provider Active NPI

Maurice Edward Reynolds, FNP-C

  • Family Nurse Practitioner
  • Willimantic, CT
National Provider Identifier
1700683406
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
14517 Issued in CT
Practice address
5 Founders St Ste 100
Willimantic, CT 06226-2049
Phone
(860) 423-9764
NPI assigned
Feb 28, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 14517 CT Primary

Addresses

Primary practice location

5 Founders St Ste 100
Willimantic, CT 06226-2049

Mailing address

1290 Silas Deane Hwy
Wethersfield, CT 06109-4337

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250331002985 CT Practitioner - Nurse Practitioner 5799208781 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartford Healthcare Medical Group IncGroup PAC ID 1153573902, 257 clinicians

Practice addresses (Care Compare)

5 Founders St
Willimantic, CT 06226-2048
Phone (860) 423-5000

Hospital & facility affiliations

  • Windham Community Memorial Hospital Hospital, Willimantic, CT, CCN 070021

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group, Inc Single Specialty CurrentSince Apr 15, 2025 Accepting new patients
Hartford Healthcare Medical Group, Inc Past Accepting new patients

Locations

676 Hebron Ave
#1
Glastonbury, CT 06033
Phone (860) 696-2250

256 N Main St
Manchester, CT 06042
Phone (860) 646-8595

55 Meriden Ave
Ste 1D
Southington, CT 06489
Phone (860) 276-5144

1025 Silas Deane Hwy
Ste 101
Wethersfield, CT 06109
Phone (877) 707-4442

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

5 Founders St
Ste 100
Willimantic, CT 06226
Phone (860) 423-9764

5 Founders St
Willimantic, CT 06226
Phone (860) 423-9764

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1740700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1700683406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1290 SILAS DEANE HWY",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061094337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 FOUNDERS ST STE 100",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262049",
            "telephone_number": "860-423-9764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "MAURICE",
        "middle_name": "EDWARD",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-02-28",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "14517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willimantic, CT

Sources for this page

Verify at the official NPI Registry.