Individual provider Active NPI

Shaun M Reynolds, M.D.

  • Emergency Medicine Physician
  • Norfolk, VA
National Provider Identifier
1821383944
Registry record updated Mar 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0101261779 Issued in VA
Practice address
3000 Coliseum Dr
Norfolk, VA 23666
Phone
(502) 852-5689
NPI assigned
Jun 16, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 01076107A IN
Emergency Medicine Physician 207P00000X 0101261779 VA Primary
Emergency Medicine Physician 207P00000X 47305 KY

Addresses

Primary practice location

3000 Coliseum Dr
Norfolk, VA 23666

Mailing address

6141 Sylvan St
Norfolk, VA 23508-1033
Phone (502) 852-5689

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20170531000485 VA Practitioner - Emergency Medicine 9436393865 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Louisville School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3000 Coliseum Dr
Hampton, VA 23666-5963
Phone (757) 736-1000

Hospital & facility affiliations

  • Sentara Careplex Hospital Hospital, Hampton, VA, CCN 490093

Merit-based Incentive Payment System (MIPS)

Final score
84.24 of 100Reported as group
Quality
75.4
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01076107AINMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians of Tidewater Emergency Medicine CurrentSince Jan 3, 2018 Accepting new patients
Emergency Medicine Associates, P.a.,P.C. CurrentSince Jun 1, 2025 Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince Jun 1, 2025 Accepting new patients
Mep Health, LLC Emergency Medicine CurrentSince Sep 28, 2022 Accepting new patients

Locations

500 Martha Jefferson Dr
Charlottesvle, VA 22911
Phone (434) 654-7000

3000 Coliseum Dr
Hampton, VA 23666
Phone (757) 736-1000

15225 Heathcote Blvd
Haymarket, VA 20169
Phone (571) 284-1000

11803 Jefferson Ave
Newport News, VA 23606
Phone (757) 594-1000

2800 Godwin Blvd
Suffolk, VA 23434
Phone (757) 363-6850

3920 Bridge Rd
Suffolk, VA 23435
Phone (757) 668-4114

Organizations & group practices 4

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 1

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": "1308182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615507200000",
    "number": "1821383944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6141 SYLVAN ST",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235081033",
            "telephone_number": "502-852-5689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 COLISEUM DR",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "23666",
            "telephone_number": "502-852-5689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "SHAUN",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-16",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01076107A",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101261779",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "47305",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.