Individual provider Active NPI

Allison B Reynolds, APRN

  • Pediatric Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1821766155
Registry record updated Dec 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
3016451 Issued in KY
Practice address
4123 Dutchmans LN Ste 102
Louisville, KY 40207-4718
Phone
(502) 559-1670
NPI assigned
Sep 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 3016451 KY
Pediatric Nurse Practitioner 363LP0200X 3016451 KY Primary

Addresses

Primary practice location

4123 Dutchmans LN Ste 102
Louisville, KY 40207-4718

Mailing address

3623 E Locust Cir
Prospect, KY 40059-9020
Phone (502) 599-1184

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20220107001942 KY Practitioner - Nurse Practitioner 2163814864 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3016451KYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Norton Children'S Medical Group, LLC CurrentSince Jan 1, 2022 Accepting new patients
Norton Children'S Medical Group, LLC Pediatrics Current Accepting new patients
Norton Children'S Medical Group, LLC CurrentSince Jan 1, 2022 Accepting new patients
Norton Childrens Medical Group, LLC Pediatrics Past Accepting new patients

Locations

3999 Dutchmans Ln
Ste 6FI
Louisville, KY 40207

601 S Floyd St
Ste 604
Louisville, KY 40202
Phone (502) 559-1670

4123 Dutchmans Ln
Ste 102
Louisville, KY 40207
Phone (502) 559-1670

231 E Chestnut St
Louisville, KY 40202
Phone (502) 852-8500

Interoperability endpoints

  • Direct secure messaging: aburger73366@direct.nortonhealthcare.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1630454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1821766155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3623 E LOCUST CIR",
            "city": "PROSPECT",
            "state": "KY",
            "postal_code": "400599020",
            "telephone_number": "502-599-1184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4123 DUTCHMANS LN STE 102",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074718",
            "telephone_number": "502-559-1670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "ALLISON",
        "middle_name": "B",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-01",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "3016451",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "KY",
            "license": "3016451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.