NPIMap

Individual provider Active NPI

Deann Reynolds, PA-C

  • Physician Assistant
  • Sparks, NV
National Provider Identifier
1871573915
Registry record updated Feb 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
404 Issued in NV
Practice address
3160 Vista Blvd
Sparks, NV 89436-6703
Phone
(775) 352-7200
Fax
(775) 352-7222
NPI assigned
Jan 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 404 NV Primary

Addresses

Primary practice location

3160 Vista Blvd
Sparks, NV 89436-6703

Mailing address

3160 Vista Blvd
Sparks, NV 89436-6703
Phone (775) 352-7200

Other identifiers 1

IdentifierTypeStateIssuer
002410026MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, MT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060113000354 NV Practitioner - Physician Assistant 0648293803 Reassigns benefits to 1 organization
I20180102002659 MT Practitioner - Physician Assistant 0648293803 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Joseph E Johnson MD and Assoc LTDGroup PAC ID 4981683976, 5 clinicians

Practice addresses (Care Compare)

3160 Vista Blvd
Sparks, NV 89436-6703
Phone 7753527200100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
404NVMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
St Peters Hospital CurrentSince Jan 8, 2018 Accepting new patients
St Peter'S Health Current Accepting new patients
St Peters Community Hospital CurrentSince Jul 1, 2018 Accepting new patients
St. Peter'S Health CurrentSince Jan 8, 2018 Accepting new patients
Jay C. Chamberlain, M.D., Inc. Past Accepting new patients

Locations

2475 E Broadway St
Helena, MT 59601
Phone (406) 442-2480

Interoperability endpoints

  • Direct secure messaging: deann.reynolds@snfm.directbygreenway.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 9

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": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551225600000",
    "number": "1871573915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3160 VISTA BLVD",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894366703",
            "telephone_number": "775-352-7200",
            "fax_number": "775-352-7222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3160 VISTA BLVD",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894366703",
            "telephone_number": "775-352-7200",
            "fax_number": "775-352-7222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "DEANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-17",
        "last_updated": "2019-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002410026",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparks, NV

Sources for this page

Verify at the official NPI Registry.