Lucia Nichole Reynolds, LMT, BCTMB

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

220.014395 Issued in IL

Practice address

2606 Broadway
Rockford, IL 61108-5768

Phone

(815) 397-3744

NPI assigned

Jan 24, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Lucia Nichole Ruiz Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Evolve Chiropractic Rockford PLLC

  • Chiropractor
  • Rockford, IL
  • NPI 1881238434
  NPD (past)

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

{
    "created_epoch": "1516752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516752000000",
    "number": "1922506005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 COLONIAL DR",
            "city": "MACHESNEY PARK",
            "state": "IL",
            "postal_code": "611153808",
            "telephone_number": "815-560-2862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2606 BROADWAY",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611085768",
            "telephone_number": "815-397-3744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "LUCIA",
        "middle_name": "NICHOLE",
        "credential": "LMT, BCTMB",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-24",
        "last_updated": "2018-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "IL",
            "license": "220.014395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LUCIA",
            "last_name": "RUIZ",
            "middle_name": "NICHOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Edgardo Apostol Reyes Jr., MD
• Jennifer Reyes
• Kristina Reyez
• Andrea L Reynolds, LMT
• Joanne Lynn Reynolds, OTR
• Amanda Rezin, LCPC
• David G. Rezin, OTR, CHT
• Janine Spain Rhoades, MD
• Randall Rhodes, MD
• Sharon K. Rhodes, MD

• Massage Therapist in Rockford, IL
• Providers in Rockford, IL by specialty
• Massage Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2018; 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.