Andrea Marie Reynolds, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

1260 Issued in ND

Practice address

2016 S Washington St
Grand Forks, ND 58201-6342

Phone

(701) 775-8934

Fax

(701) 757-4208

NPI assigned

Sep 2, 2009

Sex

Female

Sole proprietor

Yes

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

Master of Science

State licenses

Practice roles

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.

• Anne Carlsen Center

  • Physical Therapist
  • Jamestown, ND
  • NPI 1598930109

  Speech-Language Pathologist

  NPD (past)
• Anne Carlsen Center

  • Community/Behavioral Health Agency
  • Jamestown, ND
  • NPI 1659966877
  NPD (past)

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

{
    "created_epoch": "1251849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413936000000",
    "number": "1912130295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3402 CHERRY LYNN DR",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582017644",
            "telephone_number": "701-215-2030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2016 S WASHINGTON ST",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582016342",
            "telephone_number": "701-775-8934",
            "fax_number": "701-757-4208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "ANDREA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-02",
        "last_updated": "2014-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ND",
            "license": "1260",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "7602",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Restad
• Retina Consultants, LTD
• Lindsey Marie Reule, LPCC
• Nicole Reybok
• Lynn M Reynolds Cooley
• Jennifer Marie Reynolds, RN
• Jim Dale Rhoads, LSW
• Freaha Riaz, MD
• Richard P Stadter Psychiatric Center, LLC
• Paula Ricke, FNP-C

• Speech-Language Pathologist in Grand Forks, ND
• Providers in Grand Forks, ND by specialty
• Speech-Language Pathologist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2014; 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.