Matthew Reynolds

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11004883 Issued in FL

Practice address

1122 Hallamwood TRL S
Lakeland, FL 33813-1818

Phone

(863) 450-0456

NPI assigned

Sep 30, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Florida Spine and Pain InstituteGroup PAC ID 7012294556, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

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.

• Florida Spine & Pain Institute

  • Interventional Pain Medicine Physician
  • Clermont, FL
  • NPI 1053769661
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1569801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572393600000",
    "number": "1881235059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 HALLAMWOOD TRL S",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338131818",
            "telephone_number": "863-450-0456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 HALLAMWOOD TRL S",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338131818",
            "telephone_number": "863-450-0456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "MATTHEW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-30",
        "last_updated": "2019-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "FL",
            "license": "RN9317915",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11004883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Matthew@hydraivtherapy.com",
            "affiliation": "N",
            "endpointDescription": "webpage",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1122 Hallamwood Trl S",
            "city": "Lakeland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "338131818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Manuel Reyes
• Natalie Marie Reyes, M.D.
• Sarah Reyna, LMT
• Taylor Reyna
• Lauren Alexis Reynolds
• Robert Nicholas Reynolds, D.M.D
• Reza Yasrebi, MD, PA
• Angelica Rhodes
• Riaan Pharmacy LLC
• Barbara Ricardo Gonzalez

• Family Nurse Practitioner in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.