Gary Raynolds, RPH, B.S. PHARM

Primary specialty

PharmacistTaxonomy code 183500000X

License

051034225 Issued in IL

Practice address

2115 S Macarthur Blvd
Springfield, IL 62704-4501

Phone

(217) 726-1003

NPI assigned

Aug 10, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science, Doctor of Pharmacy, Registered Pharmacist

State licenses

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

{
    "created_epoch": "1439164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439164800000",
    "number": "1730565003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5197 N CARPENTER RD",
            "city": "BUFFALO",
            "state": "IL",
            "postal_code": "625157093",
            "telephone_number": "217-415-1764",
            "fax_number": "217-364-5644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 S MACARTHUR BLVD",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044501",
            "telephone_number": "217-726-1003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYNOLDS",
        "first_name": "GARY",
        "credential": "RPH, B.S. PHARM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-10",
        "last_updated": "2015-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051034225",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "008653",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Delaney Marguerite Wolf Rawson, MD
• Lauren Nicole Ray, PA-C
• Mary Ray, LPC
• Valerie A Ray, CCC-A
• Donald P Rayhill, OT
• Kristin Raynolds
• Irum Raza
• Melanie J Rdzok, LPC
• Linda J. Read, FNP-BC
• Keesha Readus

• Pharmacist in Springfield, IL
• Providers in Springfield, IL by specialty
• Pharmacist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2015; 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.