Individual provider Active NPI

Rhett Matthew Reynolds, LCSW

  • Clinical Social Worker
  • Knoxville, TN
National Provider Identifier
1710311642
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LSW6416 Issued in TN
Practice address
3105 Essary Dr
Knoxville, TN 37918-2409
Phone
(865) 687-8990
Fax
(865) 687-1190
NPI assigned
Aug 28, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LSW6416 TN Primary

Addresses

Primary practice location

3105 Essary Dr
Knoxville, TN 37918-2409

Mailing address

3105 Essary Dr
Knoxville, TN 37918-2409
Phone (865) 688-6160

Other practice location 1

626 Bernard Ave
Knoxville, TN 37921-6253
Phone (865) 522-0161 ext. 54433

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171113001473 TN Practitioner - Clinical Social Worker 4688930324 Practice locations: Knoxville, TN

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4610 Central Ave Pike
Knoxville, TN 37912-4006
Phone (865) 688-6160

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LSW6416TNMDClinical Social Worker
6416TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Helen Ross McNabb Center Past Accepting new patients
Alternative Counseling Center Past Accepting new patients
Pathways Therapy Center Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1377648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1710311642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3105 ESSARY DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379182409",
            "telephone_number": "865-688-6160",
            "fax_number": "865-687-1190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3105 ESSARY DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379182409",
            "telephone_number": "865-687-8990",
            "fax_number": "865-687-1190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "626 Bernard Ave",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379216253",
            "country_code": "US",
            "telephone_number": "865-522-0161 x54433",
            "fax_number": "865-521-7920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "RHETT",
        "middle_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-28",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "LSW6416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.