Abigail Nance McReynolds, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA06083 Issued in TX

Practice address

3010 Williams Dr
Suite 177
Georgetown, TX 78628-2764

Phone

(512) 868-3376

Fax

(512) 869-5868

NPI assigned

Apr 3, 2009

Sex

Female

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 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mountain West Derm - Blackhart PLLCGroup PAC ID 1153609813, 103 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Mountain West Derm - Blackhart PLLC

  • Dermatology Physician
  • Georgetown, TX
  • NPI 1366018848
  Medicare reassignment Care Compare group NPD
• Mountain West Derm-Blackhart, PLLC

  • Dermatology Physician
  • Tigard, OR
  • NPI 1316656994
  NPD

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

{
    "created_epoch": "1238716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372636800000",
    "number": "1821230939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3010 WILLIAMS DR",
            "address_2": "SUITE 177",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786282764",
            "telephone_number": "512-868-3376",
            "fax_number": "512-869-5868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3010 WILLIAMS DR",
            "address_2": "SUITE 177",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786282764",
            "telephone_number": "512-868-3376",
            "fax_number": "512-869-5868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCREYNOLDS",
        "first_name": "ABIGAIL",
        "middle_name": "NANCE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-03",
        "last_updated": "2013-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA06083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "289385101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Euclid Newton McLeod Jr., D.D.S.
• Gina Lynne McMaster, PT
• Devyn McNamara
• Melanie Marie McQueen, AUD
• Hazel Leigh McRae, MA, LPC
• Edward Michael McTague, PT, DPT, OCS
• Stephen Mark Meacham, D.D.S.
• Cody D Mead, D.O.
• Medical Billing Solutions, Inc.
• Jennifer Marie Medina, L.C.S.W.

• Physician Assistant in Georgetown, TX
• Providers in Georgetown, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2013; 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.