NPIMap

Individual provider Active NPI

David Lee Reynolds Jr., M.D.

  • Diagnostic Radiology Physician
  • Grand Rapids, MI
National Provider Identifier
1730107988
Registry record updated Jun 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
4301074306 Issued in MI
Practice address
3264 N Evergreen Dr NE
Grand Rapids, MI 49525-9746
Phone
(616) 363-7339
Fax
(616) 361-5828
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 4301074306 MI Primary

Addresses

Primary practice location

3264 N Evergreen Dr NE
Grand Rapids, MI 49525-9746

Mailing address

3264 N Evergreen Dr NE
Grand Rapids, MI 49525-9746
Phone (616) 363-7339

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, TN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040913001391 MI Practitioner - Diagnostic Radiology 9133196702 Reassigns benefits to 5 organizations
I20231023000117 TN Practitioner - Diagnostic Radiology 9133196702 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Wayne State University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prime Radiology Consultants P.C.Group PAC ID 7416485040, 52 clinicians
Jackson Radiology Associates PAGroup PAC ID 6305893231, 28 clinicians

Practice addresses (Care Compare)

Byron Center, MI 49315
Phone (833) 364-7790

5919 Glencroft CT
Caledonia, MI 49316-8553
Phone (731) 240-1747

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Clinic PA CurrentSince Oct 23, 2023 Accepting new patients
Prime Radiology Consultants P.C. Diagnostic Radiology CurrentSince Jun 1, 2025 Accepting new patients
Jackson Clinic PA Family Medicine CurrentSince Oct 23, 2023 Accepting new patients
Jackson Radiology Associates PA Diagnostic Radiology CurrentSince Sep 1, 2023 Accepting new patients
Jackson Madison County General Hospital Diagnostic Radiology CurrentSince Oct 1, 2025 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

274 E Chicago St
Coldwater, MI 49036
Phone (517) 279-5400

900 Cooper Ave
Saginaw, MI 48602
Phone (989) 583-6122

650 Nuckolls Rd
Bolivar, TN 38008
Phone (731) 541-6834

145 Innovation Dr
Jackson, TN 38305

620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923

9 Physicians Dr
Jackson, TN 38305
Phone (731) 661-0086

2863 Highway 45 Byp
Jackson, TN 38305
Phone (731) 660-8300

2859 Highway 45 Byp
Jackson, TN 38305
Phone (731) 660-8360

87 Murray Guard Dr
Ste B
Jackson, TN 38305
Phone (731) 664-1375

Organizations & group practices 8

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 5

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339027200000",
    "number": "1730107988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3264 N EVERGREEN DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259746",
            "telephone_number": "616-363-7339",
            "fax_number": "616-361-5828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3264 N EVERGREEN DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259746",
            "telephone_number": "616-363-7339",
            "fax_number": "616-361-5828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "DAVID",
        "middle_name": "LEE",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2012-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301074306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.