Active NPI
Dana Reynolds, M.D.
- Pediatric Endocrinology Physician
- Philadelphia, PA
National Provider Identifier
1902338031
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Endocrinology Physician
- License
- MT222178
- Practice address
- 3401 Civic Center Blvd
Division of Pediatric Endocrinology
Philadelphia, PA 19104 - Phone
- (202) 330-1012
- NPI assigned
- Mar 29, 2017
- Last updated
- Jul 5, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 0101269913 | VA | |
| Pediatric Endocrinology Physician | 2080P0205X | MT222178 | PA | Primary |
Addresses
Primary practice location
3401 Civic Center Blvd
Division of Pediatric Endocrinology
Philadelphia, PA 19104
Mailing address
3401 Civic Center Blvd
Division of Pediatric Endocrinology
Philadelphia, PA 19104
Phone (267) 426-3870
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: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101269913 | VA | MD | Pediatrics Physician |
| MT222178 | PA | MD | Pediatric Endocrinology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Childrens Hospital of the Kings Daughters Inc | Current | Accepting new patients | |
| Childrens Health Care Associates of New Jersey PC | Pediatrics | Past | Accepting new patients |
Locations
817 Volvo Pkwy
Chesapeake, VA 23320
Phone (757) 668-4630
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.
-
dba CHKD Urgent Care
- Urgent Care Clinic/Center
- Chesapeake, VA
- NPI 1578954590
-
dba Chca NJ
- Pediatrics Physician
- Voorhees, NJ
- NPI 1427152917
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625443200000",
"number": "1902338031",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3401 CIVIC CENTER BLVD",
"address_2": "DIVISION OF PEDIATRIC ENDOCRINOLOGY",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19104",
"telephone_number": "267-426-3870"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3401 CIVIC CENTER BLVD",
"address_2": "DIVISION OF PEDIATRIC ENDOCRINOLOGY",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19104",
"telephone_number": "202-330-1012"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOLDS",
"first_name": "DANA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-03-29",
"last_updated": "2021-07-05",
"certification_date": "2021-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "VA",
"license": "0101269913",
"primary": false
},
{
"code": "2080P0205X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Endocrinology",
"state": "PA",
"license": "MT222178",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.