Individual provider Active NPI

Demetra Diane Barr Reynolds, M.D.

  • Family Medicine Physician
  • Flagstaff, AZ
National Provider Identifier
1790721777
Registry record updated Feb 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
28556 Issued in AZ
Practice address
1895 N Jasper Dr Ste 3
Flagstaff, AZ 86001-1632
Phone
(928) 913-8800
NPI assigned
Jun 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A63274 CA
Family Medicine Physician 207Q00000X ME154526 FL
Family Medicine Physician 207Q00000X 28556 AZ Primary

Addresses

Primary practice location

1895 N Jasper Dr Ste 3
Flagstaff, AZ 86001-1632

Mailing address

1200 N Beaver St
Flagstaff, AZ 86001-3118
Phone (928) 213-6235

Other identifiers 1

IdentifierTypeStateIssuer
113774000MedicaidFL

Other names 1

  • Dr. Demetra Diane Barr Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050124000629 AZ Practitioner - Family Practice 8820048309 Reassigns benefits to 2 organizations
I20220322000203 FL Practitioner - Family Practice 8820048309 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, San Diego School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northern Arizona Healthcare CorporationGroup PAC ID 3577473362, 391 clinicians
Urgent Care Northern Arizona Healthcare LLCGroup PAC ID 1557875481, 12 clinicians

Practice addresses (Care Compare)

1215 N Beaver St
Suite 203
Flagstaff, AZ 86001-3126
Phone (928) 773-2249

1895 N Jasper Dr
Flagstaff, AZ 86001-1632

2000 S Thompson St
Flagstaff, AZ 86001-8759
Phone (928) 226-6400

269 S Candy LN
Cottonwood, AZ 86326-4158
Phone (928) 639-6000

Hospital & facility affiliations

  • Angels Care Home Health of Arizona No 5 Home health agency, Flagstaff, AZ, CCN 037500
  • Northern Arizona Home Health Home health agency, Flagstaff, AZ, CCN 037047
  • Flagstaff Medical Center Hospital, Flagstaff, AZ, CCN 030023
  • Verde Valley Medical Center Hospital, Cottonwood, AZ, CCN 030007

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28556AZMDFamily Medicine Physician
A63274CAMDFamily Medicine Physician
ME154526FLMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Arizona Healthcare Corporation CurrentSince Dec 15, 2024 Accepting new patients
Lee Memorial Health System CurrentSince May 9, 2022 Accepting new patients
Urgent Care Northern Arizona Healthcare LLC CurrentSince Jul 14, 2025 Accepting new patients
Flagstaff Pathology Associates Current Accepting new patients
Lee Health System Inc Family Medicine CurrentSince Oct 1, 2024 Accepting new patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients
Lee Memorial Health System Family Medicine CurrentSince May 9, 2022 Accepting new patients
Northern Arizona Healthcare Corporation Family Medicine CurrentSince Dec 15, 2024 Accepting new patients

Locations

1298 W Finnie Flat Rd
Ste 101
Camp Verde, AZ 86322
Phone (928) 639-5555

269 S Candy Ln
Cottonwood, AZ 86326
Phone (928) 634-2251

1895 N Jasper Dr
Ste 3
Flagstaff, AZ 86001
Phone (928) 213-6385

2700 S Woodlands Village Blvd
Ste 700
Flagstaff, AZ 86001
Phone (214) 674-9164

1200 N Beaver St
Flagstaff, AZ 86001
Phone (928) 213-6235

1215 N Beaver St
Ste 203
Flagstaff, AZ 86001
Phone (928) 773-2249

107 E Oak Ave
Flagstaff, AZ 86001
Phone (928) 779-7880

1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900

8931 Colonial Center Dr
Ste 401
Fort Myers, FL 33905
Phone (239) 424-2030

16271 Bass Rd
Fort Myers, FL 33908
Phone (239) 343-7100

1569 Matthew Dr
Fort Myers, FL 33907
Phone (941) 939-1700

930 S Main St
Ste C
Labelle, FL 33935
Phone (239) 674-5520

Organizations & group practices 8

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 8

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": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738800000000",
    "number": "1790721777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N BEAVER ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013118",
            "telephone_number": "928-213-6235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1895 N JASPER DR STE 3",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011632",
            "telephone_number": "928-913-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARR REYNOLDS",
        "first_name": "DEMETRA",
        "middle_name": "DIANE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-20",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A63274",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME154526",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "28556",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113774000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEMETRA",
            "last_name": "BARR",
            "middle_name": "DIANE",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Flagstaff, AZ

Sources for this page

Verify at the official NPI Registry.