Tina R Reynolds, MS, RD, CDE

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

2254 Issued in FL

Practice address

820 Prudential Dr
Suite 416
Jacksonville, FL 32207-8210

Phone

(904) 202-1553

Fax

(904) 202-2462

NPI assigned

Dec 31, 2009

Last updated

Dec 31, 2009By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1262217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262217600000",
    "number": "1710217443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 PRUDENTIAL DR",
            "address_2": "SUITE 416",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078210",
            "telephone_number": "904-202-1553",
            "fax_number": "904-202-2462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 PRUDENTIAL DR",
            "address_2": "SUITE 416",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078210",
            "telephone_number": "904-202-1553",
            "fax_number": "904-202-2462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "TINA",
        "middle_name": "R",
        "credential": "MS, RD, CDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-31",
        "last_updated": "2009-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "2254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan P Reynolds, MD
• Julia Reynolds, PT, DPT
• Macy Reynolds
• Megan Rizzi Reynolds, MS, RD, CSR, LD
• Natalie Reynolds, PA-C
• Reza Azari Samani, DDS PA
• Reza Health LLC (Reza Health)
• Reza M Taba MD PA
• Mohammed Bin Reza, MD
• Rebecca K Reza, ARNP

• Registered Dietitian in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Registered Dietitian in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.