Clyde Douglas Reynolds, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC3828 Issued in FL

Practice address

460 E Nine Mile Rd
Pensacola, FL 32514-1441

Phone

(850) 477-1499

Fax

(850) 479-3359

NPI assigned

Jan 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Dr. Douglas Reynolds Professional name

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2003

Medicare assignment

May accept Medicare assignment

Group practices

Douglas Reynolds, O.D. Santa Rosa, P.a.Group PAC ID 7113286451, 6 clinicians

Douglas Reynolds OD PAGroup PAC ID 3375584295, 8 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

80.14 of 100Reported as group

Quality

60.29

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: clyde.reynolds.1@24790.direct.athenahealth.com

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.

• Douglas Reynolds OD PA

  • Optometrist
  • Pensacola, FL
  • NPI 1023164662
  Medicare reassignment Care Compare group NPD Authorized official
• Douglas Reynolds, O.D. Santa Rosa, P.a.

  • Optometrist
  • Pace, FL
  • NPI 1891207742
  Medicare reassignment Care Compare group NPD
• F & M of Milton Inc

  • Optometrist
  • Milton, FL
  • NPI 1982790341
  NPD (past)
• Owens & Reynolds Inc

  • Optometrist
  • Pensacola, FL
  • NPI 1902128960
  NPD (past)

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

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310083200000",
    "number": "1811975634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 E NINE MILE RD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325141441",
            "telephone_number": "850-477-1499",
            "fax_number": "850-479-3359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 E NINE MILE RD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325141441",
            "telephone_number": "850-477-1499",
            "fax_number": "850-479-3359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "CLYDE",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-03",
        "last_updated": "2011-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "45012",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00229829",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DOUGLAS",
            "last_name": "REYNOLDS",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Revelations Direct Care Services
• Revolutionary Medical Supplies LLC
• Revolutionary Medical Supplies LLC
• Gaddiel Reyes
• Roy R Reyes, MD
• Kimberly Reynolds
• Richard Albert Keith Reynolds, MD
• Maryam Rezaie, D.M.D
• Rheumatology Associates
• Kamin Rhoades, MSW

• Optometrist in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.