Individual provider Active NPI

Jessica Leigh Reynolds, M.D.

  • Internal Medicine Physician
  • Spartanburg, SC
National Provider Identifier
1861786345
Registry record updated Dec 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
33622 Issued in SC
Practice address
2995 Reidville Rd Ste 210
Spartanburg, SC 29301-5631
Phone
(864) 253-8140
Fax
(864) 587-0051
NPI assigned
Jun 2, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X LL33622 SC
Internal Medicine Physician 207R00000X 33622 SC Primary

Addresses

Primary practice location

2995 Reidville Rd Ste 210
Spartanburg, SC 29301-5631

Mailing address

PO Box 743070
Atlanta, GA 30374-3070
Phone (864) 560-4304

Other identifiers 2

IdentifierTypeStateIssuer
SC77205019OtherSCMEDICARE PIN
336229MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jreynolds179679@direct-srhs.et0939.epichosted.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20160324001841 SC Practitioner - Internal Medicine 4385809912 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of South Carolina School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spartanburg Medical CenterGroup PAC ID 3072425297, 1,060 clinicians

Practice addresses (Care Compare)

2995 Reidville Rd
Spartanburg, SC 29301-5628
Phone (864) 253-8140

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.7 of 100Reported as apm
Quality
89.4
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33622SCMDInternal Medicine Physician
LL33622SCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health Medical Group-Midlands Internal Medicine CurrentSince Dec 23, 2016 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Dec 23, 2016 Accepting new patients
Spartanburg Medical Center Current Accepting new patients
Spartanburg Medical Center CurrentSince Jan 1, 2019 Accepting new patients
Spartanburg Medical Center Internal Medicine CurrentSince Jan 1, 2019 Accepting new patients
Spartanburg Medical Center Past Accepting new patients

Locations

Taylor At Marion St
Columbia, SC 29220
Phone (803) 296-3097

3 Richland Medical Park Dr
Ste 310
Columbia, SC 29203
Phone (803) 434-8323

14 Richland Medical Park Dr
Ste 320
Columbia, SC 29203
Phone (803) 434-1663

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

2995 Reidville Rd
Spartanburg, SC 29301
Phone (864) 253-8140

853 N Church St
Ste 410A
Spartanburg, SC 29303
Phone (864) 560-6928

8311 Warren H Abernathy Hwy
Spartanburg, SC 29301
Phone (864) 562-5100

101 E Wood St
Ste 300
Spartanburg, SC 29303
Phone (864) 560-6554

2995 Reidville Rd
Ste 210
Spartanburg, SC 29301
Phone (864) 253-8140

Interoperability endpoints

  • Direct secure messaging: jreynolds179679@direct-srhs.et0939.epichosted.com

Organizations & group practices 6

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 7

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": "1306972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1861786345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743070",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743070",
            "telephone_number": "864-560-4304",
            "fax_number": "864-560-4413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2995 REIDVILLE RD STE 210",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293015631",
            "telephone_number": "864-253-8140",
            "fax_number": "864-587-0051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "JESSICA",
        "middle_name": "LEIGH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-02",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "LL33622",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "33622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SC77205019",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "336229",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jreynolds179679@direct-srhs.et0939.epichosted.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "jreynolds179679@direct-srhs.et0939.epichosted.com",
            "address_1": "2995 Reidville Rd Ste 210",
            "city": "Spartanburg",
            "state": "SC",
            "country_code": "US",
            "postal_code": "293015631",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.