Alan Reynolds, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

20885020 Issued in WI

Practice address

425 Pine Ridge Blvd
Suite 211
Wausau, WI 54401-4123

Phone

(715) 845-5505

Fax

(715) 848-2884

NPI assigned

Jul 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Central Wisconsin Anesthesiology

  • Anesthesiology Physician
  • Wausau, WI
  • NPI 1518999648
  NPD (past)

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1922025873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 PINE RIDGE BLVD",
            "address_2": "SUITE 211",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014123",
            "telephone_number": "715-845-5505",
            "fax_number": "715-848-2884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 PINE RIDGE BLVD",
            "address_2": "SUITE 211",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014123",
            "telephone_number": "715-845-5505",
            "fax_number": "715-848-2884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "ALAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-16",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WI",
            "license": "20885020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SECURITY HEALTH PLAN",
            "identifier": "16086",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MANAGED HEALTH CARE",
            "identifier": "30272300",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SECURITY HEALTH MEDICAID",
            "identifier": "16086",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WPS",
            "identifier": "REYNOLDS",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30272300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Anesthesiology Physician in Wausau, WI
• Providers in Wausau, WI by specialty
• Anesthesiology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.