Individual provider Active NPI

Ana Carolina Coronado Reyna, MD

  • Pediatric Gastroenterology Physician
  • Montgomery, AL
National Provider Identifier
1790206605
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
41071 Issued in AL
Practice address
300 Taylor Rd Ste 700
Montgomery, AL 36117-3551
Phone
(334) 747-6000
Fax
(334) 747-6025
NPI assigned
Jun 30, 2017
Last updated
Mar 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X 41071 AL Primary

Addresses

Primary practice location

300 Taylor Rd Ste 700
Montgomery, AL 36117-3551

Mailing address

301 Brown Springs Rd
Montgomery, AL 36117-7005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20231117003115 AL Practitioner - Pediatric Medicine 6406204114 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41071ALMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs CurrentSince Jan 1, 2024 Accepting new patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs CurrentSince Jan 1, 2024 Accepting new patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs Current Accepting new patients
The Health Care Authority for Baptist Health Past Accepting new patients
The Health Care Authority for Baptist Health an Affiliate of Uabhs Past Accepting new patients
The Health Care Authority for Baptist Health Past Accepting new patients

Locations

2055 E South Blvd
Ste 200
Montgomery, AL 36116
Phone (334) 284-5211

2055 E South Blvd
Ste 308
Montgomery, AL 36116
Phone (334) 286-2390

300 Taylor Rd
Ste 700
Montgomery, AL 36117
Phone (334) 277-1115

301 Brown Springs Rd
Montgomery, AL 36117
Phone (334) 273-4159

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1498780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1790206605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 BROWN SPRINGS RD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361177005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 TAYLOR RD STE 700",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361173551",
            "telephone_number": "334-747-6000",
            "fax_number": "334-747-6025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORONADO REYNA",
        "first_name": "ANA CAROLINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-30",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "AL",
            "license": "41071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.