Jay M Reynolds, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

013765 Issued in ME

Practice address

23 High St
Fort Fairfield, ME 04742-1021

Phone

(207) 768-4753

Fax

(207) 768-4748

NPI assigned

Jul 15, 2006

Last updated

Jul 16, 2008By the provider in NPPES

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 10

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216166400000",
    "number": "1821014275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 HIGH ST",
            "city": "FORT FAIRFIELD",
            "state": "ME",
            "postal_code": "047421021",
            "telephone_number": "207-768-4753",
            "fax_number": "207-768-4748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 HIGH ST",
            "city": "FORT FAIRFIELD",
            "state": "ME",
            "postal_code": "047421021",
            "telephone_number": "207-768-4753",
            "fax_number": "207-768-4748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "JAY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2008-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "013765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "046597",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "ME0366",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "3320494",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "260600099",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA NON HMO",
            "identifier": "5385624",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "AS OF 5/1/98",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARTINS POINT",
            "identifier": "002824",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "138128908",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BENEFIT SERVICES",
            "identifier": "AS OF 7/1/05",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "M93691",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tresa Jo Morgan, MD
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• Christine Marie O'Meara, R.N.
• Pines Health Services (Pines Kimball Community Health Center)
• Darsey L. Plourde, MHRT-CSP
• Rite Aid of Maine Inc (Rite Aid Pharmacy 03894)
• Caleigh Melissa Roberge
• Michelle Rochester
• Megan Marie Ruest, CNP211613
• School Administrative District #20

• Family Medicine Physician in Fort Fairfield, ME
• Providers in Fort Fairfield, ME by specialty
• Family Medicine Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2008; 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.