Individual provider Active NPI

Rylan Reynolds, CRNA

  • Certified Registered Nurse Anesthetist
  • Brea, CA
National Provider Identifier
1821327602
Registry record updated Jan 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
NA95000134 Issued in CA
Practice address
130 Copa de Oro Dr
Brea, CA 92823-7013
Phone
(657) 275-9145
NPI assigned
Dec 8, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 0024168626 VA
Certified Registered Nurse Anesthetist 367500000X NA95000134 CA Primary

Addresses

Primary practice location

130 Copa de Oro Dr
Brea, CA 92823-7013

Mailing address

130 Copa de Oro Dr
Brea, CA 92823-7013
Phone (657) 275-9145

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
95000134CAMDFamily Nurse Practitioner
NA95000134CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Oasis Anesthesia LLC Current Accepting new patients
Anesthesia Associates of Richmond, Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1260230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451779200000",
    "number": "1821327602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 COPA DE ORO DR",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928237013",
            "telephone_number": "657-275-9145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 COPA DE ORO DR",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928237013",
            "telephone_number": "657-275-9145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "RYLAN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-08",
        "last_updated": "2016-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024168626",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "NA95000134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brea, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2016; 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.