Active NPI
Kerriann Reynolds, LMSW
- Social Worker
- Troy, NY
National Provider Identifier
1780258525
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 114690-01
- Practice address
- 127 Bloomingrove Dr
Troy, NY 12180-8404 - Phone
- (518) 283-4921
- NPI assigned
- May 17, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Social Worker | 1041S0200X | NY | ||
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Social Worker | 104100000X | 114690-01 | NY | Primary |
Addresses
Primary practice location
127 Bloomingrove Dr
Troy, NY 12180-8404
Mailing address
127 Bloomingrove Dr
Troy, NY 12180-8404
Phone (518) 283-4921
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
| License | State | Type | Specialty |
|---|---|---|---|
| 114690-01 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636502400000",
"number": "1780258525",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "127 BLOOMINGROVE DR",
"city": "TROY",
"state": "NY",
"postal_code": "121808404",
"telephone_number": "518-283-4921"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "127 BLOOMINGROVE DR",
"city": "TROY",
"state": "NY",
"postal_code": "121808404",
"telephone_number": "518-283-4921"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOLDS",
"first_name": "KERRIANN",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-05-17",
"last_updated": "2021-11-10",
"certification_date": "2021-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041S0200X",
"taxonomy_group": "",
"desc": "Social Worker, School",
"state": "NY",
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "114690-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Troy, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.