Active NPI
Ivyn Scott Reynolds, BSC PHARM
- Pharmacist
- Spokane, WA
National Provider Identifier
1871887356
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH 00042413
- Practice address
- 5520 N Division St
Spokane, WA 99208-1211 - Phone
- (509) 489-6010
- NPI assigned
- Jun 2, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH 00042413 | WA | Primary |
Addresses
Primary practice location
5520 N Division St
Spokane, WA 99208-1211
Mailing address
9105 N Dusk CT
Spokane, WA 99208-5176
Phone (509) 489-2800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH 00042413 | WA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Washington CVS Pharmacy LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
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": "1306972800000",
"number": "1871887356",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9105 N DUSK CT",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992085176",
"telephone_number": "509-489-2800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5520 N DIVISION ST",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992081211",
"telephone_number": "509-489-6010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOLDS",
"first_name": "IVYN",
"middle_name": "SCOTT",
"name_prefix": "Mr.",
"credential": "BSC PHARM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-06-02",
"last_updated": "2011-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH 00042413",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.