Wylenthia Lynn Reynolds, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

056.008726 Issued in IL

Practice address

101 N Walnut St
Pinckneyville, IL 62274-1034

Phone

(618) 357-5935

Fax

(618) 357-6336

NPI assigned

Oct 17, 2006

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 names 1

• Wylenthia Lynn Johnson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Magnolia Medical Group Inc

  • Physical Therapist
  • Greenville, SC
  • NPI 1386629558

  Occupational Therapist

  NPD (past)

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339632000000",
    "number": "1851472120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12842 COUNTY HIGHWAY 27",
            "city": "NASHVILLE",
            "state": "IL",
            "postal_code": "622632612",
            "telephone_number": "618-314-4431",
            "fax_number": "618-537-5987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 N WALNUT ST",
            "city": "PINCKNEYVILLE",
            "state": "IL",
            "postal_code": "622741034",
            "telephone_number": "618-357-5935",
            "fax_number": "618-357-6336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "WYLENTHIA",
        "middle_name": "LYNN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2012-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.008726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WYLENTHIA",
            "last_name": "JOHNSON",
            "middle_name": "LYNN",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Miles Priebe
• Stephen C Priebe, PAC
• Meredith Kay Ramsey, OTR/L
• Donald Lee Renk, C.R.N.A.
• Christopher D Reyes, M.D.
• Charles Wilson Roe X, D.D.S.
• John Rosecrans, M.S. ED., ATC
• Atkavi Sawadisavi, MD
• Alyssa M Schmale, R.PH
• Kimberly Schramke

• Occupational Therapist in Pinckneyville, IL
• Providers in Pinckneyville, IL by specialty
• Occupational Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2012; 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.