Individual provider Active NPI

Joseph Michael Reynolds, D.O.

  • Family Medicine Physician
  • Wichita, KS
National Provider Identifier
1740628403
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
05-43611 Issued in KS
Practice address
14700 W Saint Teresa St
Wichita, KS 67235-9601
Phone
(316) 274-0142
Fax
(316) 719-1033
NPI assigned
Jun 4, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 05-43611 KS Primary

Addresses

Primary practice location

14700 W Saint Teresa St
Wichita, KS 67235-9601

Mailing address

901 S Kansas Ave
Topeka, KS 66612-1210
Phone (785) 783-4080

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240703003548 KS Practitioner - Family Practice 2567781966 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ascension Medical Group Via Christi PAGroup PAC ID 2961314497, 184 clinicians

Practice addresses (Care Compare)

14700 W Saint Teresa St
300 Via Christi Clinic PA
Wichita, KS 67235-9630
Phone (316) 274-0142

Hospital & facility affiliations

  • Phoenix Home Care Home health agency, Wichita, KS, CCN 178012
  • Via Christi Hospital Wichita St Teresa, Inc Hospital, Wichita, KS, CCN 170200
  • Ascension Via Christi Rehabilitation Hospital, Inc Inpatient rehabilitation facility, Wichita, KS, CCN 173028

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group Via Christi, PA Multi-Specialty CurrentSince Jun 1, 2024 Accepting new patients
Ascension Medical Group Via Christi, PA CurrentSince Jun 1, 2024 Accepting new patients
Ascension Medical Group Via Christi, PA Past Accepting new patients

Locations

3311 E Murdock St
Wichita, KS 67208
Phone (316) 689-9107

14700 W Saint Teresa St
Ste 300
Wichita, KS 67235
Phone (316) 274-0142

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.

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": "1370304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1740628403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 S KANSAS AVE",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666121210",
            "telephone_number": "785-783-4080",
            "fax_number": "833-673-0416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14700 W SAINT TERESA ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672359601",
            "telephone_number": "316-274-0142",
            "fax_number": "316-719-1033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "JOSEPH",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-04",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "05-43611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.