Individual provider Active NPI

Jeffrey R McReynolds, CNMT

  • Nuclear Medicine Technology Radiologic Technologist
  • Gladwin, MI
National Provider Identifier
1750437083
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nuclear Medicine Technology Radiologic TechnologistTaxonomy code 2471N0900X
License
025519 Issued in MI
Practice address
515 Quarter St
Gladwin, MI 48624-1959
Phone
(989) 246-9611
NPI assigned
Jan 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Medicine Technology Radiologic Technologist 2471N0900X 025519 MI Primary

Addresses

Primary practice location

515 Quarter St
Gladwin, MI 48624-1959

Mailing address

708 E Saint Andrews Rd
Midland, MI 48642-3662

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
025519MIMDNuclear Medicine Technology Radiologic Technologist

NPI Registry JSON

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

{
    "created_epoch": "1169856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750437083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 E SAINT ANDREWS RD",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486423662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 QUARTER ST",
            "city": "GLADWIN",
            "state": "MI",
            "postal_code": "486241959",
            "telephone_number": "989-246-9611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCREYNOLDS",
        "first_name": "JEFFREY",
        "middle_name": "R",
        "credential": "CNMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471N0900X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Nuclear Medicine Technology",
            "state": "MI",
            "license": "025519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gladwin, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.