Individual provider Active NPI

Eric Reynolds, NP-C

  • Family Nurse Practitioner
  • Vernal, UT
National Provider Identifier
1710311279
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5669941-4405 Issued in UT
Practice address
1680 W Highway 40 Ste 201
Vernal, UT 84078-4135
Phone
(801) 429-2000
NPI assigned
Sep 2, 2013
Last updated
May 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5669941-4405 UT Primary

Addresses

Primary practice location

1680 W Highway 40 Ste 201
Vernal, UT 84078-4135

Mailing address

589 S State St
Provo, UT 84606-5056
Phone (801) 420-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20140916000789 UT Practitioner - Nurse Practitioner 9537388038 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

589 S State St
Provo, UT 84606-5056
Phone (801) 429-2000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mountainlands Community Health Center, Inc Family Medicine CurrentSince Jul 29, 2014 Accepting new patients
Mountainlands Community Health Center, Inc. Family Medicine CurrentSince Jul 29, 2014 Accepting new patients
Mountainlands Community Health Center, Inc Family Medicine Past Accepting new patients

Locations

299 E 900 S
Ste 101
Provo, UT 84606
Phone (801) 374-9660

589 S State St
Provo, UT 84606
Phone (801) 420-2000

133 S 500 E
Vernal, UT 84078
Phone (435) 247-1177

1680 W Highway 40
Vernal, UT 84078

1680 W Highway 40
Ste 201
Vernal, UT 84078
Phone (435) 789-2024

Interoperability endpoints

  • Direct secure messaging: eric.reynolds.1@11721.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 6

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": "1378080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1710311279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "589 S STATE ST",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846065056",
            "telephone_number": "801-420-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 W HIGHWAY 40 STE 201",
            "city": "VERNAL",
            "state": "UT",
            "postal_code": "840784135",
            "telephone_number": "801-429-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "ERIC",
        "name_prefix": "Mr.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-02",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "5669941-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vernal, UT

Sources for this page

Verify at the official NPI Registry.