Garth Kyle Reynolds, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

51288648 Issued in IL

Practice address

204 W Cook St
Springfield, IL 62704-2526

Phone

(217) 522-7300

Fax

(217) 522-7349

NPI assigned

Oct 13, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

Practice roles

Locations

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.

• Illinois Pharmacists Management Enterprises, LLC

  • Pharmacist
  • Springfield, IL
  • NPI 1619774296
  NPD Authorized official

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360108800000",
    "number": "1902895873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1837 S WALNUT ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044047",
            "telephone_number": "217-522-7300",
            "fax_number": "217-522-7349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 W COOK ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627042526",
            "telephone_number": "217-522-7300",
            "fax_number": "217-522-7349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "GARTH",
        "middle_name": "KYLE",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-13",
        "last_updated": "2013-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2002028993",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "51288648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angelique S. Rettig, M.D.
• Allison Kate Retzer, MD
• Nicolas Joseph Revelt, MD
• Revolution Health and Performance, PLLC
• Davanna Jo Ayako Reynolds
• Gracie J Reynolds, APN
• James R Reynolds, HIS
• Maren Leigh Reynolds, RN
• Megan Renee Reynolds
• Melanie R Reynolds, FNP

• Pharmacist in Springfield, IL
• Providers in Springfield, IL by specialty
• Pharmacist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.