Individual provider Active NPI

Reynold Johnson Jr.

  • Internal Medicine Physician
  • Lake Mary, FL
National Provider Identifier
1871233874
Registry record updated Jul 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME173485 Issued in FL
Practice address
525 Technology Park Ste 109
Lake Mary, FL 32746-7107
Phone
(407) 647-2346
NPI assigned
Mar 30, 2022
Last updated
Jul 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME173485 FL Primary

Addresses

Primary practice location

525 Technology Park Ste 109
Lake Mary, FL 32746-7107

Mailing address

119 Oakfield Dr
Brandon, FL 33511-5779

Other practice location 1

119 Oakfield Dr
Brandon, FL 33511-5779
Phone (813) 681-5551

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20251031000006 FL Practitioner - Internal Medicine 9335520683 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of South Florida College of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inpatient Care Specialists LLCGroup PAC ID 0345493623, 101 clinicians

Practice addresses (Care Compare)

1451 El Camino Real
The Villages, FL 32159-0041
Phone (407) 647-2346

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME173485FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Florida Inpatient Medicine LLC Internal Medicine CurrentSince Nov 1, 2025 Accepting new patients
Inpatient Care Specialists LLC CurrentSince Oct 1, 2025 Accepting new patients

Locations

502 W Highland Blvd
Inverness, FL 34452
Phone (352) 344-6481

525 Technology Park
Ste 109
Lake Mary, FL 32746
Phone 4076472346 ext. 111

1451 El Camino Real
The Villages, FL 32159
Phone (352) 751-8000

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

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": "1648598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752710400000",
    "number": "1871233874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 OAKFIELD DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 TECHNOLOGY PARK STE 109",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327467107",
            "telephone_number": "407-647-2346"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "119 Oakfield Dr",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "FL",
            "postal_code": "335115779",
            "country_code": "US",
            "telephone_number": "813-681-5551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "REYNOLD",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-30",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME173485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

Verify at the official NPI Registry.