Paul S Reynolds, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50-002251 Issued in OH

Practice address

18697 Bagley Rd
Cleveland, OH 44130-3417

Phone

(440) 816-8000

NPI assigned

Dec 23, 2005

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 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Southwest General Health Center

  • Physician Assistant
  • Cleveland, OH
  • NPI 1740608306
  Medicare reassignment NPD
• Southwest General Medical Group Inc

  • Internal Medicine Physician
  • Cleveland, OH
  • NPI 1134239676
  Medicare reassignment NPD (past)
• Southwest General Medical Group Inc

  • Durable Medical Equipment & Medical Supplies
  • Middleburg HTS, OH
  • NPI 1588393979
  NPD

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

{
    "created_epoch": "1135296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184112000000",
    "number": "1841277456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 634434",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452630001",
            "telephone_number": "440-879-0081",
            "fax_number": "440-879-0084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18697 BAGLEY RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441303417",
            "telephone_number": "440-816-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "PAUL",
        "middle_name": "S",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-23",
        "last_updated": "2007-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50-002251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000359356",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marisa R Reynolds
• Marshanita Reynolds, LPN
• Meagan Sarah Reynolds, AGACNP
• Nicholaus Reynolds
• Nicole M. Reynolds, CNP
• Renay E Reynolds
• Robert W Reynolds, MD
• Tameka Reynolds
• Tanaysha Reynolds
• Tye Shae Reynolds, LSW

• Physician Assistant in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.