Active NPI
Jennifer Butler Reynaldo, PA-C
- Medical Physician Assistant
- Virginia Beach, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 0110001711
- Practice address
- 1120 First Colonial Rd
Suite 100
Virginia Beach, VA 23454-2418 - Phone
- (757) 481-2333
- Fax
- (757) 481-1037
- NPI assigned
- Dec 6, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | PA030295 | DC | |
| Physician Assistant | 363A00000X | 25MP00171700 | NJ | |
| Medical Physician Assistant | 363AM0700X | 0110001711 | VA | Primary |
Addresses
Primary practice location
1120 First Colonial Rd
Suite 100
Virginia Beach, VA 23454-2418
Mailing address
1120 First Colonial Rd
Suite 100
Virginia Beach, VA 23454-2418
Phone (757) 481-2333
Other names 1
- Jennifer J Butler
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Eastern Virginia Medical School, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
8644 Sudley Rd
Suite 220
Manassas, VA 20110-4425
Phone (571) 366-8845
950 N Glebe Rd
Suite 700
Arlington, VA 22203-4173
Hospital & facility affiliations
- Sentara Home Care Services-Virginia Beach
- Sentara Virginia Beach General Hospital
- Sentara Princess Anne Hospital
- Sentara Leigh Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MP00171700 | NJ | MD | Physician Assistant |
| 0110001711 | VA | MD | Medical Physician Assistant |
| PA030295 | DC | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Privia Medical Group, LLC | Current | Accepting new patients | |
| Privia Medical Group, LLC | Current | Accepting new patients | |
| Nova Physician Wellness Center PLLC | Past | Accepting new patients |
Locations
8644 Sudley Rd
#220
Manassas, VA 20110
324 Louisa Ave
Ste 125
Virginia Beach, VA 23454
Phone (757) 351-6400
1120 First Colonial Rd
Ste 100
Virginia Beach, VA 23454
Phone (757) 481-2333
Interoperability endpoints
- https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
- jennifer.reynaldo.2@8042.direct.athenahealth.com
Organizations & group practices 3
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.
-
- Internal Medicine Physician
- Arlington, VA
- NPI 1013042480
-
- Pain Medicine (Psychiatry & Neurology) Physician
- Rockville, MD
- NPI 1811715436
-
- Family Medicine Physician
- Fairfax, VA
- NPI 1215307400
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Chesapeake, VA
- NPI 1710425152
-
- General Acute Care Hospital
- Virginia Beach, VA
- NPI 1629038336
-
- General Acute Care Hospital
- Norfolk, VA
- NPI 1811957681
-
- General Acute Care Hospital
- Virginia Beach, VA
- NPI 1528028396
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447113600000",
"number": "1891779468",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1120 FIRST COLONIAL RD",
"address_2": "SUITE 100",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234542418",
"telephone_number": "757-481-2333",
"fax_number": "757-481-1037"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1120 FIRST COLONIAL RD",
"address_2": "SUITE 100",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234542418",
"telephone_number": "757-481-2333",
"fax_number": "757-481-1037"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNALDO",
"first_name": "JENNIFER",
"middle_name": "BUTLER",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-06",
"last_updated": "2015-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "DC",
"license": "PA030295",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NJ",
"license": "25MP00171700",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "VA",
"license": "0110001711",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "BUTLER",
"middle_name": "J",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Virginia Beach, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2015; 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.