NPIMap

Individual provider Active NPI

Patricia S Reynolds, P.A.C.

  • Medical Physician Assistant
  • Williamsburg, VA
National Provider Identifier
1740221407
Registry record updated May 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0110003329 Issued in VA
Practice address
117 Bulifants Blvd Ste B
Williamsburg, VA 23188-5712
Phone
(757) 259-9540
NPI assigned
Jun 10, 2006
Last updated
May 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0110003329 VA Primary

Addresses

Primary practice location

117 Bulifants Blvd Ste B
Williamsburg, VA 23188-5712

Mailing address

400 Sentara Cir Ste 320
Williamsburg, VA 23188-5716
Phone (757) 345-4800

Other practice location 1

400 Sentara Cir
Suite 320
Williamsburg, VA 23188-5716
Phone (757) 345-4800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130227000283 VA Practitioner - Physician Assistant 1456339696 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
George Washington University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Physician Services IncGroup PAC ID 5092608448, 793 clinicians

Practice addresses (Care Compare)

117 Bulifants Blvd
Suite B
Williamsburg, VA 23188-5712
Phone (757) 259-9540

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110003329VAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Physicians Multispecialty Group PC CurrentSince Jan 1, 2023 Accepting new patients
New Era Healthcare Inc. CurrentSince Oct 6, 2025 Accepting new patients

Locations

729 Thimble Shoals Blvd
Newport News, VA 23606
Phone (757) 874-1077

827 Diligence Dr
Ste 100
Newport News, VA 23606

860 Omni Blvd
Ste 105
Newport News, VA 23606
Phone (757) 873-0952

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BGFHDD

Organizations & group practices 4

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 3

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": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779321600000",
    "number": "1740221407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 SENTARA CIR STE 320",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231885716",
            "telephone_number": "757-345-4800",
            "fax_number": "757-345-4801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 BULIFANTS BLVD STE B",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231885712",
            "telephone_number": "757-259-9540"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Sentara Cir",
            "address_2": "Suite 320",
            "address_purpose": "LOCATION",
            "city": "Williamsburg",
            "state": "VA",
            "postal_code": "231885716",
            "country_code": "US",
            "telephone_number": "757-345-4800",
            "fax_number": "757-345-4801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "PATRICIA",
        "middle_name": "S",
        "credential": "P.A.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-10",
        "last_updated": "2026-05-21",
        "certification_date": "2026-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110003329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, VA

Sources for this page

Verify at the official NPI Registry.